Continuous intra-arterial chemotherapy for downstaging locally advanced oral commissure carcinoma

Head Neck. 2014 Jul;36(7):1027-33. doi: 10.1002/hed.23408. Epub 2013 Sep 18.

Abstract

Background: The purpose of this study was to assess the usefulness, safety, and efficacy of intra-arterial (IA) infusion chemotherapy for patients with locally advanced oral commissure cancer.

Methods: Twenty-one patients with stages III and IV squamous cell carcinoma involving the mouth angle were recruited. Methotrexate (MTX; 50 mg/day) was continuously infused into the external carotid artery for a mean period of 8 days, followed by weekly IA bolus of 25 mg MTX for a mean period of 10 weeks.

Results: Thirteen patients (62%) achieved a complete response (CR) and 7 patients (33%) had a partial response (PR). At a median follow-up of 69 months, the estimated 1-year, 3-year, and 5-year survival rates of the patients with CR versus PR were 100% versus 57%, 92% versus 43%, and 80% versus 43%, respectively.

Conclusion: Our data demonstrate that continuous IA chemotherapy could achieve a competitive acceptable survival rate and improved locoregional control of advanced oral commissure cancer.

Keywords: chemotherapy; intra-arterial infusion; methotrexate; oral commissure; squamous cell carcinoma.

MeSH terms

  • Adult
  • Aged
  • Antimetabolites, Antineoplastic / administration & dosage*
  • Antimetabolites, Antineoplastic / adverse effects
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carotid Artery, Internal
  • Disease-Free Survival
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Infusions, Intra-Arterial / methods
  • Lip Neoplasms / drug therapy*
  • Lip Neoplasms / mortality
  • Lip Neoplasms / pathology
  • Male
  • Methotrexate / administration & dosage*
  • Methotrexate / adverse effects
  • Middle Aged
  • Mouth Mucosa / pathology
  • Retrospective Studies

Substances

  • Antimetabolites, Antineoplastic
  • Methotrexate