Efficacy of concurrent chemoradiotherapy with superselective intra-arterial docetaxel-nedaplatin for metastatic cervical lymph nodes in oral cancers

Wataru KOBAYASHI; Hisashi SATO; Hirotaka SAKAKI; Hirosi NAKAGAWA; Kousei KUBOTA; Kenji NARITA; Takao KON; Norihiko NARITA; Beng Gwan THE; Hiroto KIMURA

doi:10.11277/stomatology.61.8

ORIGINAL ARTICLES

Efficacy of concurrent chemoradiotherapy with superselective intra-arterial docetaxel-nedaplatin for metastatic cervical lymph nodes in oral cancers

Wataru KOBAYASHI, Hisashi SATO, Hirotaka SAKAKI, Hirosi NAKAGAWA, Kousei KUBOTA, Kenji NARITA, Takao KON, Norihiko NARITA, Beng Gwan THE, Hiroto KIMURA

Author information

Wataru KOBAYASHI
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine
Hisashi SATO
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine
Hirotaka SAKAKI
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine
Hirosi NAKAGAWA
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine
Kousei KUBOTA
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine
Kenji NARITA
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine
Takao KON
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine
Norihiko NARITA
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine
Beng Gwan THE
Department of Dentistry and Oral and Maxillofacial Surgery, Misawa City Hospital
Hiroto KIMURA
Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine

Keywords: oral cancer, cervical lymph node metastasis, superselective intra-arterial infusion, chemoradiotherapy

JOURNAL FREE ACCESS

2012 Volume 61 Issue 1 Pages 8-15

DOI https://doi.org/10.11277/stomatology.61.8

Details

Abstract

The purpose of this study was to evaluate the efficacy of concurrent chemoradiation with intra-arterial docetaxel-nedaplatin infusion to metastatic cervical lymph nodes in oral cancers. Sixteen patients with advanced oral cancer accompanied by cervical lymph node metastasis were treated between 2003 and 2009 at Hirosaki University Hospital. A total of 66 Gy of external beam irradiation concurrent with 2 to 3 courses of intra-arterial chemotherapy infusion via the femoral artery with a combination of docetaxel (40 mg/m²) and nedaplatin (80 mg/m²) was conducted. Amongst the 16 patients, 6 received a total anticancer drug delivery to the primary tumor and 10 received a partial delivery to the nodal disease. The feeding artery to the nodal disease was the facial artery in 3 patients and the occipital artery in 3 patients. The remaining 4 patients received anticancer drug infusion to the external carotid artery with arterial redistribution technique where embolization was applied in order to achieve an antitumor effect due to a high local concentration. Treatment effect was evaluated by computed tomography (CT), magnetic resonance imaging and positron emission tomography-CT (PET-CT). Metastatic cervical lymph nodes disappeared in 15 out of the 16 patients (93.8%) post-treatment. Neck dissection was performed for the patient with residual nodal disease. One patient had neck recurrence at level V in ipsilateral neck. The three-year overall survival rate was 74.6% with a median follow-up duration of 27 months.
Conclusion: Intra-arterial docetaxel-nedaplatin infusion concurrent with radiotherapy is an effective treatment not only for primary disease but also for metastatic cervical lymph nodes.

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