2010 Volume 36 Issue 1 Pages 9-15
Three cases, in which intra-arterial cisplatinum chemotherapy of the ethmoid and/or orbital portion of advanced maxillary antrum cancer (T4a or T4b) combined with concurrent radiotherapy (RADPLAT) was conducted, are presented to discuss the feasibility of this radical treatment. Those tumors seemed uncontrollable with intra-arterial chemotherapy only through the external carotid artery and radiotherapy because there was no tumor staining on the external carotid artery angio-CT. Those tumors, on the other hand, showed intense tumor staining when internal carotid artery (ophthalmic artery) angio-CT was performed. The treatment was initiated upon obtaining the patient's informed consent in addition to the informed consent obtained at chemotherapy through the external carotid artery. The amount of CDDP administered via the ophthalmic artery ranged from 50-100mg per infusion and from 200-275mg in total (given over three to four courses). All patients showed CR and two survived without disease. As a significant complication, all patients went blind on the affected side in about two weeks. No other significant complications including those related to infusion techniques were encountered. Intra-arterial chemotherapy via the ophthalmic artery may be a final treatment of choice in advanced maxillary antrum cancers with ethmoid and/or orbital extension to better control the tumor while avoiding facial disfigurement.
