Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for T2-4N0 tongue cancer: control of occult neck metastasis
Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for T2-4N0 tongue cancer: control of occult neck metastasis
复制标题
DOI：
10.1016/j.oooo.2017.02.004
复制
发表时间：
2017-07-01
影响因子：
2.9
通讯作者：
Tohnai, Iwai
中科院分区：
文献类型：
--
作者：
Minamiyama, Shuhei;Mitsudo, Kenji;Tohnai, Iwai
Objective.评价T2- 4 N 0口腔舌鳞癌患者行逆行超选择动脉内化疗和每日同步放疗的治疗结果和隐匿性颈部转移的控制。42例T2- 4 N 0舌癌患者（17例晚期T2; 13例T3; 12例T4 a疾病，M0）接受动脉内放化疗。治疗包括逆行超选择动脉内化疗（多西他赛50-70 mg/m2，顺铂125-175 mg/m2）和每日同步放疗（50-70戈伊）5-7周。所有患者的中位随访时间为46.5个月（范围：8-105个月）。42例中有42例（100%）达到了原发部位完全缓解。3年总生存率、无进展生存率和局部控制率分别为85.0%、77.8%和91.7%。42例中有5例（11.9%）出现颈淋巴结延迟转移。3级或4级毒性变化包括92.9%的口腔粘膜炎，21.4%的中性粒细胞减少症和4.8%的血小板减少症。3级毒副反应包括贫血16.7%、放射性皮炎9.5%、恶心4.8%、发热2.4%。T2- 4 N 0舌癌的逆行超选择动脉内化疗提供了良好的总生存率和局部控制率，并对隐匿性颈部转移有效。
Objective. To evaluate the therapeutic results and control of occult neck metastasis in patients with T2-4N0 oral tongue squamous cell carcinoma treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy.Study Design. Forty-two patients with T2-4N0 tongue cancer (17 with late T2; 13 with T3; and 12 with T4a disease, M0) were treated with intra-arterial chemoradiotherapy. Treatment consisted of retrograde superselective intra-arterial chemotherapy (docetaxel 50-70 mg/m(2), cisplatin 125-175 mg/m(2)) and daily concurrent radiotherapy (50-70 Gy) for 5-7 weeks.Results. The median follow-up for all patients was 46.5 months (range, 8-105 months). Primary-site complete response was achieved in 42 of 42 cases (100%). Three-year overall survival, progression-free survival, and local control rates were 85.0%, 77.8%, and 91.7%, respectively. Delayed neck metastasis was detected in 5 of 42 cases (11.9%). Grade 3 or 4 toxic changes included oral mucositis in 92.9%, neutropenia in 21.4%, and thrombocytopenia in 4.8%. Grade 3 toxicities included anemia in 16.7%, radiation dermatitis in 9.5%, nausea in 4.8%, and fever in 2.4%.Conclusions. Retrograde superselective intra-arterial chemotherapy for T2-4N0 tongue cancer provided good overall survival and local control rates and was effective for occult neck metastasis.