RT Journal Article
SR Electronic
T1 Intra-Arterial High-Dose Chemotherapy with Cisplatin as Part of a Palliative Treatment Concept in Oral Cancer
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1804
OP 1809
VO 26
IS 7
A1 S. Rohde
A1 A. F. Kovács
A1 B. Turowski
A1 B. Yan
A1 F. Zanella
A1 J. Berkefeld
YR 2005
UL http://www.ajnr.org/content/26/7/1804.abstract
AB BACKGROUND AND PURPOSE: Patients with cancer of the oral cavity often present with advanced tumor stages, distant metastasis, or severe comorbidities, which render radical surgery infeasible. The purpose of this study was to investigate the response rate, technical feasibility, and safety of intra-arterial (IA) chemotherapy as palliative treatment in this situation.METHODS: From November 1997 to December 2003, 64 patients with histologically proven oral squamous cell carcinoma, classified as inoperable, received IA high-dose chemotherapy with cisplatin as a palliative treatment at our institution. To minimize toxic side effects, sodium thiosulfat was given intravenously.Twenty-eight percent of the patients were female; average age was 61.5 years. Clinical staging of primary tumors was TNM (tumor, nodules, metastases) stage IV in 89%, stage III in 6.3% and stage II in 4.7%. After local chemotherapy, additional radiation of the tumor area or radiochemotherapy was performed in 33 patients.RESULTS: There were no major catheter-related complications or severe side effects of IA chemotherapy. After the first cycle, 10% percent of the patients had complete remission (CR), 35% had partial response (PR), and 43.3% presented with stable disease.Mean follow-up interval was 11 ± 12.9 months. Forty-five patients died after a mean period of 7.6 ± 7.0 months (median, 5.1 months). The overall 1- and 2-year survival rates were 29.5% and 18%, respectively. There was a trend toward longer survival in patients who received subsequent radiation or radiochemotherapy after IA chemotherapy.CONCLUSION: IA chemotherapy in patients with inoperable carcinoma of the oral cavity as palliative treatment was technically feasible and safe. The overall response rate after IA chemotherapy was 45% (CR 10%; PR 35%). Side effects could be minimized by neutralizing the cytotoxic agent by sodium thiosulfat.