Abstract
Concurrent superselective intra-arterial chemoradiotherapy (SIACRT), a combination of chemoradiotherapy (CRT) and superselective intra-arterial chemotherapy (SIAC), is a new therapeutic strategy for advanced squamous cell carcinomas (SCCs) of the head and neck. We have been applying SIACRT for SCC of the maxillary sinus and upper gingiva since 2008 and present herein the outcomes at our hospital. SIACRT was applied in 10 cases between 2009 and 2012, 7 males and 3 females with an age-range of 57 to 81. An intra-arterial micro-catheter was inserted into a feeding artery of the tumor super-selectively using Seldinger’s method. Cisplatin (CDDP) was injected into the tumor intra-arterially through the catheter at a rate of 5 mg per minute. At the same time sodium thiosulfate (STS) was intravenously administered at 200-fold the dose of CDDP in a molar quantity to reduce the toxicity of the CDDP. Irradiation was started on the same day.
5-day-continuous intravenous administration of 5-fluorouracil (5FU) was started the next day. CDDP and 5FU were administered in the same way 4 weeks later. The total dose of irradiation was 50 to 60 Gy. In 8 cases, the protocol was applied correctly, and these patients showed complete response (CR) and survived without disease for more than 15 months. In 2 cases, the patient dropped out of the protocol, resulting in partial response (PR). Of these cases, 1 refused the 2nd administration of SIAC and in the other 2 courses of SIAC followed by SIACRT were administered. In 2 of the 8 CR cases, the application of SIACRT eliminated metastatic lymph node tumors.
