Effectiveness of superselective intra-arterial chemoradiotherapy for N3 cervical lymph node metastasis

—a report of two cases of oral cancers—

Abstract

Two oral cancer patients with N3 lymph nodes in level II metastases were treated with superselective intra-arterial chemoradiotherapy. A total dose of 66Gy/33 fractions of external beam irradiation concurrent with 3 to 4 courses of intra-arterial chemotherapy infusion via the femoral artery with a combination of docetaxcel (40mg/m²) and nedaplatin (80mg/m²) was administered. All patients received anticancer drug infusion to the external carotid artery with a redistribution technique whereby embolization was applied in order to achieve an antitumor effect due to a high concentration. Both the primary tumor and huge lymph node metastases disappeared and neck dissection was not performed in any of the patients. Multiple distant metastases developed in one patient who received systemic chemotherapy unsuccessfully. There was no local recurrence in the primary tumor or lymph nodes. Superselective intra-arterial chemoradiotherapy was an effective treatment not only for primary disease but also for metastatic N3 lymph nodes.