Combined intra-arterial infusion and systemic chemoradiotherapy for stage IV squamous cell carcinoma of the mandibular gingiva

• DOI: 10.1007/s11604-012-0122-3
• Publication Date: 2012-08-30T21:07:27Z
• Authors: Tatsuhiko Nakasato; Mitsuru Izumisawa; Akio Akahane; Koyo Kikuchi; Shigeru Ehara; Satoru Shoji; Shintaro Kogi; Harumi Mizuki; Yoshiki Sugiyama
• Keywords: Aged, 80 and over; Male; Gingival Neoplasms; Antineoplastic Agents; Chemoradiotherapy; Docetaxel; Mandible; Middle Aged; Combined Modality Therapy; Drug Administration Schedule; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Carcinoma, Squamous Cell; Humans; Infusions, Intra-Arterial; Female; Taxoids; Fluorouracil; Cisplatin; Aged

The purpose of this study was to show the effectiveness of combining intra-arterial infusion and systemic chemotherapy with concurrent radiotherapy for treatment of stage IV mandibular gingival cancer.A total of 23 patients with mandibular gingival cancer were treated with either docetaxel by intra-arterial infusion followed by systemic chemoradiotherapy with cisplatinum and 5-fluorouracil as a monthly regimen, or with docetaxel and cisplatinum by intra-arterial infusion followed by systemic chemoradiotherapy with 5-fluorouracil as a weekly or biweekly regimen. Tumor responses, locoregional control, overall survival, disease-specific survival, and adverse events were evaluated.Of the 23 patients enrolled in the study, 22 completed the treatment. With regard to clinical stages, 82 % were diagnosed as IVA and 18 % IVB. Complete and partial response was observed in 82 and 18 %, respectively. Five-year overall survival, disease-specific survival, and locoregional control were 51, 70, and 72 %, respectively. No statistically significant difference was seen between the monthly regimen and the weekly plus biweekly regimen, although the latter resulted in longer survival and 88 % control.Combined intra-arterial infusion and systemic chemoradiotherapy may be an effective treatment for patients with stage IV mandibular gingival cancer.