舌癌に対して舌・顔面動脈共通幹から舌動脈を経由して超選択的動注化学放射線療法を施行した1例

抄録

Intra-arterial chemoradiotherapy applied to the superficial temporal artery for oral cancer has been attracting increasing attention. We report a case of tongue cancer treated with superselective intra-arterial injection chemoradiotherapy via the lingual artery branched out of the common trunk of the lingual and facial arteries. The patient was a 65-year-old male, who presented with a tumor mass on the right edge of the tongue. The ulcerated area spread from the right edge to the posterior of the tongue, and was 50×30mm in size. It was pathologically diagnosed as squamous cell carcinoma in a biopsy. Metastasis to the lymph nodes in the neck was not present, and the condition was clinically diagnosed as squamous cell carcinoma of the tongue (T3N0M0). To prevent functional disorders that might result from surgery, superselective intra-arterial chemoradiotherapy on the superficial temporal artery was planned. The common trunk of the lingual and facial arteries was identified in an angiography of the external carotid artery, and a catheter was superselectively placed in the lingual artery. Intra-arterial chemoradiotherapy (DOC: 45mg/m², CDDP: 75mg/m², Linac 30 Gy) was performed for 3 weeks, but it was interrupted since pain and delirium due to oral mucositis were observed. However, a biopsy after treatment did not detect tumor cells and the clinical effect was determined to be complete response, thus avoiding a resection of the primary lesion. Eight years have passed since the treatment, but there are no signs of relapse or metastasis, and the patient is doing well.