Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for T2-4N0 tongue cancer: Control of occult neck metastasis

Publication date: Available online 21 February 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Shuhei Minamiyama, Kenji Mitsudo, Yuichiro Hayashi, Masaki Iida, Toshinori Iwai, Hideyuki Nakashima, Senri Oguri, Tomomichi Ozawa, Toshiyuki Koizumi, Makoto Hirota, Mitomu Kioi, Iwai Tohnai
ObjectiveTo 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 DesignForty 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/m², cisplatin 125-175 mg/m²) and daily concurrent radiotherapy (50-70 Gy) for 5-7 weeks.ResultsThe median follow-up for all patients was 46.5 (range, 8-105) months. Primary site complete response was achieved in 42 (100%) of 42 cases. 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 (11.9%) of 42 cases. Grade 3 or 4 toxic changes included oral mucositis in 92.9%, neutrophil count decreased in 21.4%, and platelet count decreased 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%.ConclusionsRetrograde superselective intra-arterial chemotherapy for T2-4N0 tongue cancer provided good overall survival and local control rates, and was effective for occult neck metastasis.



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