Intraarterial Infusion Chemotherapy for Head and Neck Cancers: Evaluation of Tumor Perfusion with Intraarterial CT during Carotid Arteriography with a Combined CT and Angiography System

头颈癌的动脉内灌注化疗：联合 CT 和血管造影系统进行颈动脉造影时通过动脉内 CT 评估肿瘤灌注

• 批准号: 13670951
• 负责人: KOROGI Yukunori
• 金额: $ 2.24万
• 依托单位: Kumamoto University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13670951/
• 关键词: Squamous cell carcinoma of the head and neck; interventional radiology; catheter; carotid artery; Intraarterial chemotherapy; a combined CT and angiography system; preoperative radiotherapy; 頸動脈

We have performed superselective intraarterial infusion chemotherapy for the cancer of the mouth combined with medium dose conformal radiotherapy. Two or three infusions of CDDP (40mg/body) are performed with superselective catheterization of a microcatheter via the femoral artery approach. The conformal radiotherapy is planned by three to five ports and the total and daily doses delivered are 30Gy and 2.0Gy, respectively.We evaluated drug distribution in the carcinomas with CT during intraarterial contrast-material injection for superselective intraarterial infusion of the anti-cancer agents, and to evaluate the perfusion in the carcinomas with intraarterial dynamic CT, using a combined CT and angiography system. After the feeding vessels were identified by enhancement of the tumor on CT of the selected vessel, cisplatin was injected through the microcatheter placed in each artery depending on tumor location. Histopathologic effects were evaluated after surgery and classified into five grades.The intraarterial, slow-infusion dynamic CT was useful for detection of the extent of the tumor. In the qualitative evaluation, tumors showed early and strong enhancement as well as rapid washout comparing to the adjacent normal tissues, and dynamic CT was useful for evaluation of the extent of the tumor. When multiple feeders existed, the dose of cisplatin for each feeder could be determined by the percentage of tumor enhanced with CT on each vascular injection. However, quantitative data did not provide additional information in prediction of the treatment effect. This might indicates that the effectiveness of intraarterial chemotherapy is not directly affected by the perfusion of the head and neck cancers.

我们对口腔癌进行了超选择动脉灌注化疗联合中剂量适形放疗。通过股动脉入路超选择性微导管插入术进行两次或三次CDDP（40 mg/人）输注。适形放射治疗计划分3 ~ 5个野，总剂量30 Gy，日剂量2.0Gy，采用CT和血管造影相结合的方法，在动脉灌注造影剂的同时，用CT评价肿瘤内药物分布，用动脉动态CT评价肿瘤灌注。在通过所选血管的CT上的肿瘤增强来识别供血血管后，根据肿瘤位置通过放置在每个动脉中的微导管注射顺铂。术后评价肿瘤组织学分级，动脉内慢灌注动态CT对肿瘤范围的判断有重要价值。在定性评价中，肿瘤与邻近正常组织相比表现为早期强强化和快速洗脱，动态CT有助于评估肿瘤的范围。当存在多个供血动脉时，每个供血动脉的顺铂剂量可以通过每次血管注射的CT增强肿瘤百分比来确定。然而，定量数据没有提供额外的信息来预测治疗效果。提示头颈部肿瘤的灌注情况并不直接影响动脉化疗的疗效。