口腔癌に対する超選択的動注化学療法―臓器温存治療を目指して―

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  • Superselctive intra-arterial chemotherapy for oral cancer -Toward the therapy of organ preservation-
  • 第39・40回教育研修会(2013年口腔四学会合同研修会)「口腔癌の診断と治療 : 基礎から最新の治療まで」 口腔癌に対する超選択的動注化学療法 : 臓器温存治療を目指して
  • ダイ39 ・ 40カイ キョウイク ケンシュウカイ(2013ネン コウコウ ヨン ガッカイ ゴウドウ ケンシュウカイ)「 コウコウ ガン ノ シンダン ト チリョウ : キソ カラ サイシン ノ チリョウ マデ 」 コウコウ ガン ニ タイスル チョウセンタクテキドウ チュウ カガク リョウホウ : ゾウキ オンゾン チリョウ オ メザシテ

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Intra-arterial infusion for oral cancer exists in 3 methods, historically. The conventional method is catheterization into the external carotid artery via a superficial temporal artery or a superior thyroid artery. The catheterization of the conventional method is relatively easily, however, the concentration of the anticancer drug in the tumor is uncertain. Superselective intra-arterial chemoradiotherapy using Seldinger method of the catheterization into the tumor-feeding artery via a femoral artery contributed considerably to treatment for head and neck cancer, however, have a problem with safety. On the other hand, retrograde superselective intra-arterial chemotherapy using HFT method of the catheterizations into the tumor-feeding artery via a superficial temporal artery and an occipital artery has safety and the concentration of the anticancer drug using this method is certain. One hundred and twelve patients with stage III and IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy using HFT method. Treatment consisted of superselective intra-arterial chemotherapy (DOC: total 60 mg/m2, CDDP: total 150mg/m2) and daily concurrent radiotherapy (total 60Gy) for 6 weeks. Primary site complete response was achieved in 98 (87.5%) of 112 cases. Five-year survival and local control rates were 71.3% and 79.3%, respectively. This treatment method will be promising to noninvasive therapy for advanced oral cancer.

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