INTRA-ARTERIAL CHEMOTHERAPY WITH SEVERAL ANTICANCER AGENTS FOR ORAL CANCER

Abstract

Intra-arterial chemotherapy in combination with radiotherapy is useful for the treatment of cancer in the head and neck, but severe side effects have been reported. Therefore, a safe treatment with which the incidence of systemic side effects is low is required. We developed a new combination intra-arterial and intra-venous chemotherapy with docetaxel (TXT), cisplatin (CDDP), peplomycin (PEP), and 5-FU (TCPF intra-arterial chemotherapy), and evaluated its usefulness and safety. The subjects were 29 patients with oral squamous cell carcinoma. A catheter for intra-arterial administration was inserted via the superficial temporal artery or occipital artery. Continuous intra-arterial administration of 15 mg/m² TXT (day 1-5) and 10 mg/body PEP (day 6-10), intra-arterial administration of 7-15 mg/m² TXT (day 3) and 15-30 mg/m² CDDP (day 4), and continuous intravenous administration of 250 mg/body/day 5FU (day 1-10) were performed as 1 course. The second course was performed 4 weeks after the completion of the first course in patients for whom it was required. Radiotherapy was additionally performed in 7 patients with locally-advanced cancer or metastasis in the neck. In 25 patients, excision biopsy or radical excision was performed after the completion of this treatment. The effects of this method on the primary lesions were CR 23/29 (79%), PR 6/29 (21%), and pathological CR 13/26 (50%). As the side effects, no cerebrovascular disorder was detected, but grades 2-3 mucositis and alopecia on the intra-arterial administration side were observed, without marked systemic disorders. These results indicated that this chemotherapy was very useful and safe, and can be applied to high-risk elderly patients as a radical treatment method.