Superselective Continuous Arterial Infusion Chemotherapy through the Superficial Temporal Artery for Oral Cavity Tumors
Tatsuhiko Nakasatoa,b,
Kenichi Katoha,
Miyuki Sonea,
Shigeru Eharaa,
Yoshiharu Tamakawaa,
Hideki Hoshia and
Saburoh Sekiyamaa
a From the Department of Radiology, Iwate Medical University School of Medicine (T.N., K.K., M.S., S.E., Y.T.); and the Department of Oral Surgery II, Iwate Medical University School of Dentistry (H.H., S.S.), Morioka, Japan.
b Address reprint requests to Tatsuhiko Nakasato, MD, Department of Radiology, Iwate Medical University School of Medicine, 19–1 Uchimaru, Morioka 020–8505, Japan.
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FIG 1. Superselective catheterization in a 62-year-old man with tongue cancer (T1N0M0).
A–D, The guiding catheter was placed near the origin of the target vessel by using a guidewire (A). A vascular mapping study was done of the ECA (arrow, LA; B), after which a coaxial microcatheter was advanced through the guiding catheter into the feeding artery (C), and superselective lingual arteriography was performed (D). ICA, internal carotid artery; ECA, stem of external carotid artery; LA, lingual artery; FA, facial artery; IMA, internal maxillary artery.
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FIG 2. Protocols of chemotherapy and radiation therapy. BLM, bleomycin; MTX, methotrexate; CDDP, cisplatin
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FIG 3. A and B, Photographs show infusion apparatus attached to catheter system (A) and a patient with a catheter placed by means of a coaxial system (B)
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FIG 4. 64-year-old man with gingival cancer (T2N0M0, stage II). The tumor in the lower gingiva of the molar region disappeared after treatment.
A, Before treatment.
B, After two courses of chemotherapy with superselective catheterization and radiation therapy (40 Gy).
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FIG 5. Overall survival rate of patients with cancer of the oral cavity
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FIG 6. 72-year-old woman with tongue cancer (T1N1M0, stage III). The tumor in the lateral aspect of tongue was not detected after treatment.
A, Before treatment.
B, After two courses of chemotherapy with superselective catheterization and radiation therapy (60 Gy).
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FIG 7. Overall survival rate of patients with tongue cancer
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FIG 8. Superselective catheterization of the sharply angled feeding artery in a 44-year-old man with tongue cancer (T1N0M0).
A–C, The lingual artery is sharply angled (arrow, A). A coaxial microcatheter was introduced initially into the internal carotid (or occipital) artery to make the tip of the catheter J-shaped (B), then the catheter tip was turned around and pulled back, resulting in superselective catheterization into the feeding artery (C). ICA, internal carotid artery; ECA, stem of external carotid artery; LA, lingual artery; FA, facial artery; IMA, internal maxillary artery.
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