Chemoradiotherapy using retrograde superselective intra-arterial infusion for tongue cancer: Analysis of therapeutic results in 118 cases
Chemoradiotherapy using retrograde superselective intra-arterial infusion for tongue cancer: Analysis of therapeutic results in 118 cases
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DOI：
10.1016/j.oraloncology.2018.02.002
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发表时间：
2018-04-01
期刊：
影响因子：
4.8
通讯作者：
Tohnai, Iwai
中科院分区：
文献类型：
--
作者：
Mitsudo, Kenji;Hayashi, Yuichiro;Tohnai, Iwai
目的：目的探讨舌鳞癌患者行逆行超选择动脉内放化疗的疗效及器官保存率。材料与方法：2006年6月至2015年6月，对118例舌癌患者行动脉内放化疗。治疗包括放疗（总剂量50-70戈伊）和每日动脉内化疗（多西他赛，总剂量50-70 mg/m2;顺铂，总剂量125-175 mg/m2），持续5-7周。采用Kaplan-Meier法计算局部控制率和总生存率。考克斯的比例风险模型用于单变量和多变量analysis.Results：所有患者的中位随访时间为38.5个月（范围，3-129个月）。动脉内放化疗后，113例（95.8%）原发部位完全缓解。3年局部控制率和总生存率分别为80.3%和81.5%。3级或4级毒性包括16.1%的中性粒细胞减少和87.3%的粘膜炎。3级毒性包括12.7%的贫血、3.4%的血小板减少、3.4%的恶心/呕吐、45.7%的皮炎、74.6%的吞咽困难和2.5%的发热。4.2%的患者发生晚期毒性，包括3级颌骨放射性骨坏死。在单因素分析中，T分期和总体分期与局部区域控制显著相关，N分期和总体分期与总体生存显著相关。在多变量分析中，总生存率的唯一显着的预测因素是整体分期classification.Conclusion：逆行超选择性动脉内放化疗舌癌提供了良好的总生存率和局部控制。
Objectives: To evaluate the therapeutic results and rate of organ preservation in patients with squamous cell carcinoma of the tongue treated with retrograde superselective intra-arterial chemoradiotherapy.Materials and methods: Between June 2006 and June 2015, 118 patients with tongue cancer were treated with intra-arterial chemoradiotherapy. Treatment consisted of radiotherapy (total 50-70 Gy) and daily concurrent intra-arterial chemotherapy (docetaxel, total 50-70 mg/m(2); cisplatin, total 125-175 mg/m(2)) for 5-7 weeks. Locoregional control and overall survival rates were calculated by the Kaplan-Meier method. Cox's proportional hazards model was used for both univariate and multivariate analyses.Results: The median follow-up for all patients was 38.5 months (range, 3-129 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 113 (95.8%) of 118 cases. Three-year locoregional control and overall survival rates were 80.3% and 81.5%, respectively. Grade 3 or 4 toxicities included neutropenia in 16.1% and mucositis in 87.3%. Grade 3 toxicities included anemia in 12.7%, thrombocytopenia in 3.4%, nausea/vomiting in 3.4%, dermatitis in 45.7%, dysphagia in 74.6%, and fever in 2.5% of patients. Late toxicity consisting of grade 3 osteoradionecrosis of the jaw occurred in 4.2% of patients. On univariate analysis, T stage and overall stage were significantly associated with locoregional control, and N stage and overall stage were significantly associated with overall survival. On multivariate analysis, the only significant predictor of overall survival was overall stage classification.Conclusion: Retrograde superselective intra-arterial chemoradiotherapy for tongue cancer provided good overall survival and locoregional control.