2001 Fiscal Year Final Research Report Summary
Superselective mtra-arterial chemotherapy and concurrent radiotherapy for patients with advanced oral cancer
| Project/Area Number |
10671918
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Surgical dentistry
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| Research Institution | University of Occupational and Environmental Health |
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Principal Investigator |
IKEMURA Kunio University of Occupational and Environmental Health Faculty of Medicine, Research Associate, 医学部, 教授 (90038894)
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| Co-Investigator(Kenkyū-buntansha) |
TAKAGI Shinji University of Occupational and Environmental Health, Faculty of Medicine, Research Associate, 医学部, 助手 (40269072)
OYA Ryoichi University of Occupational and Environmental Health, Faculty of Medicine, Research Associate, 医学部, 助手 (70194313)
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| Project Period (FY) |
1998 – 2001
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| Keywords | oral cancer / superselective intra-arterial infusin / carboplatin / hyperfractionation / UFT(R) / complete response / hematological toxicity / intratumoral microvessel count |
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| Research Abstract |
To avoid or reduce the toxicity of carboplatin infused via the nutrient artery of tumors, the mode of dosage calculation was changed ; that is, it was calculated on the basis of the area under the curve (AUC) using the Calvert formula, instead of use of body surface. Concurrent hyperfractionated radiotherapy (5 days/week in twice-daily fractions of 1.5 Gy, a total dose of 30 Gy) and oral administration of UFT^R (400 - 600 mg/day) during radiotherapy were conducted as well as the previous scheme.
Twenty patients with aggressive/advanced oral and oropharyngeal squamous cell carcinoma (T2-4) were enrolled and 18 (90%) patients showed complete response. There was no grade 4 hematological toxicity, and grade 3 hematological toxicity was recognized in 3 (15%) patients. It means that this treatment method allows good control of the primary tumor without severe hematological toxicity. In comparison to supradose (150 mg/m2/week x 4) intra-arterial (EA) cisplatin and concurrent radiotherapy reported by Robbins et al, which is used on world-wide scale, our method does not need pre and posthydration and the neutralizing agent (sodium thiosulfate) for the cisplatin, and IA infusion in this method is one time in most patients and a total irradiation dose is usually about half (30 Gy) that of their method (68-72 Gy).
High efficacy at the primary site allows less invasive surgery, because of scar contraction of the region occupied by the tumor, and it contributes to a minimal disturbance of QOL. Moreover, this method made usual neck dissection possible in two cases with the metastatic cervical lymph node adhered to the carotid artery.
In the experiment using 26 rabbits, intratumoral microvessel counts strongly correlates to platinum concentration in the tumor (r=.875) and microvessel analysis of the specimen taken from 40 patients suggested that more vascular tumors show better response to chemoradiotherapy.
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