Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for T2–4N0 tongue cancer: control of occult neck metastasis

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Abstract

Objective.

To evaluate the therapeutic results and control of occult neck metastasis in patients with T2–4N0 oral tongue squamous cell carcinoma treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy.

Study Design.

Forty-two patients with T2–4N0 tongue cancer (17 with late T2; 13 with T3; and 12 with T4a disease, M0) were treated with intra-arterial chemoradiotherapy. Treatment consisted of retrograde superselective intra-arterial chemotherapy (docetaxel 50–70 mg/m2, cisplatin 125–175 mg/m2) and daily concurrent radiotherapy (50–70 Gy) for 5–7 weeks.

Results.

The median follow-up for all patients was 46.5 months (range, 8–105 months). Primary-site complete response was achieved in 42 of 42 cases (100%). Three-year overall survival, progression-free survival, and local control rates were 85.0%, 77.8%, and 91.7%, respectively. Delayed neck metastasis was detected in 5 of 42 cases (11.9%). Grade 3 or 4 toxic changes included oral mucositis in 92.9%, neutropenia in 21.4%, and thrombocytopenia in 4.8%. Grade 3 toxicities included anemia in 16.7%, radiation dermatitis in 9.5%, nausea in 4.8%, and fever in 2.4%.

Conclusions.

Retrograde superselective intra-arterial chemotherapy for T2–4N0 tongue cancer provided good overall survival and local control rates and was effective for occult neck metastasis.

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