Nihon Jibiinkoka Gakkai kaiho · 2012
[Usefulness and indication of superselective intra-arterial chemotherapy via the radial artery for advanced head and neck cancer--aN indication for inaccessible to treatment with seldingers method].
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Yokoyama Junkichi, Ito Shin, Ohba Shinichi, Fujimaki Mitsuhisa, Ikeda Katsuhisa, Hanaguri Makoto
Аннотация
UNLABELLED: Neck metastasis is the most significant predictive indicator of head and neck cancer. Various treatments including surgery and chemoradiation have typically resulted in poor outcomes. As a result, we have applied progressive interventional radiology (IVR), Seldinger's method, in cases deemed to have poor prognostic factors. However, a recurring problem with the standard procedure has been cases in which the target artery cannot be successfully accessed. As a result of this limitation, we have initiated an approach whereby we proceed from the radial artery in order to control neck metastasis.
OBJECTIVE: Evaluate the usefulness of superselective intra-arterial chemotherapy via the radial artery for advanced head and neck cancer.
METHOD AND PATIENTS: From May, 1998 to December 2010, 25 patients for whom catheter insertion in the thyrocervical artery, a major branch of the subclavian artery, was impossible, were treated using superselective intra-arterial chemotherapy via the radial artery. Intra-arterial chemotherapy was administered at 100-150 mg/m2 of CDDP and 10-15 mg/m2 of DOC four times per week, with 60 Gy radiation therapy being concurrently. Analysis of the success of insertion, duration of time required for insertion to the target artery, chemotherapy effective rates, and method safety were carried out retrospectively.
RESULT: For the target arteries in which catheters could not be effectively inserted using Seldinger's method, insertion was successful and CDDP was safely administered. No complications in regards to intra-arterial chemotherapy were observed. The mean time to insert the catheter into the target arteries was approximately 25 minutes. In contrast, when applying Seldinger's method the mean time was over 1 hour with the result being failure to insert the catheter within the target arteries. Working with our approach, the effective rate of chemotherapy recorded was 100%. The 5-year overall survival rate was 38%. Furthermore, the patients could walk and move freely on the day of treatment.
CONCLUSION: This novel method proved useful for the treatment of advanced head and neck cancer in poor prognostic cases in which the target arteries could not be accessed using Seldinger's method.
OBJECTIVE: Evaluate the usefulness of superselective intra-arterial chemotherapy via the radial artery for advanced head and neck cancer.
METHOD AND PATIENTS: From May, 1998 to December 2010, 25 patients for whom catheter insertion in the thyrocervical artery, a major branch of the subclavian artery, was impossible, were treated using superselective intra-arterial chemotherapy via the radial artery. Intra-arterial chemotherapy was administered at 100-150 mg/m2 of CDDP and 10-15 mg/m2 of DOC four times per week, with 60 Gy radiation therapy being concurrently. Analysis of the success of insertion, duration of time required for insertion to the target artery, chemotherapy effective rates, and method safety were carried out retrospectively.
RESULT: For the target arteries in which catheters could not be effectively inserted using Seldinger's method, insertion was successful and CDDP was safely administered. No complications in regards to intra-arterial chemotherapy were observed. The mean time to insert the catheter into the target arteries was approximately 25 minutes. In contrast, when applying Seldinger's method the mean time was over 1 hour with the result being failure to insert the catheter within the target arteries. Working with our approach, the effective rate of chemotherapy recorded was 100%. The 5-year overall survival rate was 38%. Furthermore, the patients could walk and move freely on the day of treatment.
CONCLUSION: This novel method proved useful for the treatment of advanced head and neck cancer in poor prognostic cases in which the target arteries could not be accessed using Seldinger's method.