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Observational Study
. 2019 Jan;145(1):261-268.
doi: 10.1007/s00432-018-2784-4. Epub 2018 Oct 31.

Short-term intra-arterial infusion chemotherapy for head and neck cancer patients maintaining quality of life

Karl R Aigner  1 , Emir Selak  2 , Kornelia Aigner  2
Affiliations
Observational Study

Short-term intra-arterial infusion chemotherapy for head and neck cancer patients maintaining quality of life

Karl R Aigner et al. J Cancer Res Clin Oncol. 2019 Jan.

Abstract

Purpose: Head and neck cancer treatment achieves good locoregional tumor control rates while causing severe side effects. Therapy with chemotherapeutic drugs administered intravenously is limited because either the concentrations at the tumor site are too low or the total dosages are too high. The evaluation of a technique for short-term intra-arterial infusion chemotherapy is described herein.

Methods: In a retrospective study, we reviewed the medical records of 97 patients with head and neck cancers who received short-term intra-arterial infusion chemotherapy (62 patients previously untreated, 35 patients with prior radiotherapy). All patients refused further radiotherapy. Response rates, overall survival and adverse effects were the study endpoints. The blood supply of the tumors was controlled with indigocarmine blue infusion and staining of the tumor region.

Results: Complete or partial response was found in 67%, 52% and 63% of previously untreated patients and in 25%, 30% and 29%, respectively, of previously irradiated patients for staging groups I-III, IVA and IVB/C. Patients with T3/T4 tumors who were previously irradiated showed a median overall survival of 9 months, and those without pretreatment showed a median overall survival of 22.5 months. None of the patients required tube feeding. No new case of dysphagia, xerostomia, or functional speech and hearing loss was reported. Pain and clinical symptoms were reduced for all patient groups. Indigocarmine staining showed reduced tumor blood supply in previously irradiated regions but good blood supply in untreated regions.

Conclusions: Short-term intra-arterial infusion chemotherapy achieves promising response rates and lacks severe adverse effects.

Keywords: Head and neck cancer; Intra-arterial chemotherapy; Quality of life; Regional chemotherapy.

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Conflict of interest statement

Karl Reinhard Aigner declares that he has no conflict of interest. Emir Selak declares that he has no conflict of interest. Kornelia Aigner declares that she has no conflict of interest.

Figures

Fig. 1
Fig. 1
Scheme of isolated thoracic perfusion combined with intra-arterial short-term infusion via a jetport allround catheter. Due to the reduced circulating blood volume, tumors are exposed to higher concentrations of cytotoxics
Fig. 2
Fig. 2
a, b Preirradiated areas do not stain after intra-arterial injection of blue dye, while non-irradiated and well-vascularized areas stain blue
Fig. 3
Fig. 3
Survival times for head and neck cancer patients after short-term intra-arterial chemotherapy. Patients were clustered into staging groups and survival times were estimated with the Kaplan–Meier product limit estimator
Fig. 4
Fig. 4
a and b: Median and overall survival rates for HNC patients with and without prior irradiation
See this image and copyright information in PMC

References

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