Transcatheter arterial chemoembolization is safe and effective for patients with late-stage or recurrent oral carcinoma

Abstract

Objective: We reported the long-term outcomes of transcatheter chemoembolization (TACE) for patients with late-stage or recurrent oral carcinoma.

Methods: This retrospective study enrolled 18 patients with late-stage or recurrent oral carcinoma between December 2015 and April 2021. The tumor-feeding artery was catheterized, and cisplatin/oxaliplatin and 5-FU/raltitrexed were infused with embolization using polyvinyl alcohol or gelatin sponge. Computed tomography was performed at about 1, 3, and 6 months after the procedure, and every 6 months after that. During the procedure and follow-up, procedure outcomes, complications, treatment efficacy, and overall survival were analyzed.

Results: A total of 31 sessions of TACE were performed, with a technical success rate of 100%. Of 12 patients combined with oral hemorrhage, two patients showed rebleeding 35 and 37 days later, with a clinical efficiency of hemostasis of 88.9%. Mild complications were observed in 11 patients (61.1%). Severe complications or procedure-related deaths were not observed during or after the procedure. The objective response rate and disease control rate were 20.0% and 86.7%, 38.5% and 61.5%, and 25.0% and 50.0% at 1, 3, and 6 months later, respectively. Seventeen patients (94.4%) were followed up, with a median duration of 37.8 months (IQR 22.3-56.8). Nine patients died of tumor progression, one died of massive rebleeding, and one died of severe lung infection. The median overall survival was 23.8 months.

Conclusion: TACE is a safe and effective procedure with minimal invasiveness for treating late-stage or recurrent oral carcinoma. TACE can be recommended as a palliative treatment, particularly for patients with oral hemorrhage.

Keywords: TACE; complications; oral carcinoma; oral hemorrhage; oxaliplatin; raltitrexed.

Figure 1

TACE for a 56-year male with recurrent squamous cells carcinoma after tongue cancer resection. (A, B) A recurrent tumor (arrow) was shown by laryngoscopy and computed tomography. (C) The tumor was histopathologically diagnosed as squamous cells carcinoma. (D) Tumor staining (*) was shown by angiography. (E, F) Laryngoscopy and computed tomography confirmed that the tumor disappeared 7 months after TACE.

Figure 2

A 53-year male treated by TACE for recurrent mucoepidermoid carcinomas in tongue. (A, B) Computed tomography showed a recurrent tumor with Iodine-125 seeds (arrow). (C, D) Tumor staining (*) was shown by angiography, which disappeared after TACE. (E, F) A decreased tumor (arrow) was shown by computed tomography examination about 1 month later.

Figure 3

TACE for a 63-year male with oral hemorrhage due to recurrent squamous cells carcinoma in mandible and maxilla. (A) Computed tomography showed a tumor (*) in right mandible and maxilla. (B) Numerous bone metastases were visible in systemic bone imaging. (C) Tumor staining (arrow) and varies blood vessels were shown by angiography. (D) The tumor staining and tumor-feeding arteries disappeared after TACE. (E) Iodine-125 seeds implantation was performed about 1 month after TACE. (F) The tumor (*) decreased 4 months after TACE.