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AJNR - American Journal of Neuroradiology

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Intra-Arterial High-Dose Chemotherapy with Cisplatin as Part of a Palliative Treatment Concept in Oral Cancer

S. Rohde^a, A. F. Kovács^b, B. Turowski^a, B. Yan^a, F. Zanella^a and J. Berkefeld^a

^a Institute of Neuroradiology, Johann Wolfgang Goethe-University Medical School, Frankfurt am Main, Germany
^b Department of Maxillofacial Surgery, Johann Wolfgang Goethe-University Medical School, Frankfurt am Main, Germany

View larger version (19K): [in a new window]   FIG 1. Flowchart of the study design. Patients with inoperable cancer of the oral cavity received IA chemotherapy as palliative treatment. Additional regional radiotherapy (RT) or radiochemotherapy (RCT) was performed when physical conditions were appropriate.

View larger version (111K): [in a new window]   FIG 2. Superselective catheterization of a patient with advanced cancer of the gingiva of the lower mandible. A guiding catheter is introduced into the main stem of the external carotid artery (ACE) and a selective angiogram is performed (A). A coaxial microcatheter is then advanced into the facial artery (FA) via the guiding catheter. (B). Superselective angiography of the facial artery shows small tumor-feeding vessels originating from the main trunk and a submental branch of the FA (black arrows). LA indicates lingual artery; IMA, internal maxillary artery; white star, tip of the guiding catheter in the ACE stem; white triangle, tip of the microcatheter.

View larger version (14K): [in a new window]   FIG 3. Kaplan-Meier analysis of survival rates (in %) up to 24 months after intraarterial chemotherapy with high-dose cisplatin (total number of patients = 61, including lost follow-up); after selective chemotherapy alone (n = 29) and after IA chemotherapy followed by radiation (RT) or radiation combined with systemic chemotherapy (RCT) (n = 32).