Abstract
We investigated the treatment outcome of 31 patients (stage II: 5, III: 7, IV: 19) who had enforced superselective intra-arterial infusion with cisplatin (50 mg/week) for 3-4 weeks and concurrent radiotherapy (total dose: 40-60 Gy) (RADPLAT) for head and neck squamous cell carcinoma from December 2003 to January 2009. The mean age of the patients was 65.9 years, ranging from 40 to 82 years. Intra-arterial infusion was performed once a week by Seldinger's method. In primary tumors, the response rate was 100%, and the complete response rate was 71.0%. In cervical lymph node metastasis of level I and II, the complete response rate was 92.6%. The survival rate in each location was 79.5%, 83.3%, 60.0% and 66.7% in the tongue, oral floor, upper and lower gingival carcinoma, respectively. Out of 18 cases histopathologically examined, 10 cases demonstrated a cytological effect of grade III or more in the classification of Ohoshi and Shimosato. Among them, 9 cases were tongue and oral floor carcinoma.
Although 3 patients showed grade 3 mucositis and 17 patients showed grade 3 or more leucopenia as toxicities, all patients were able to complete the scheduled treatments. Therefore, RADPLAT is a superior treatment method for head and neck squamous carcinoma, and is suggested to be useful for organ preservation as a treatment method for tongue and oral floor carcinoma and cervical lymph node metastasis of level I and II.
