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Liu T, Yang L, Li Z, Sun M, Lv N. f25, a novel synthetic quinoline derivative, inhibits tongue cancer cell invasion and survival by the PPAR pathway in vitro and vivo. Chem Biol Interact 2024; 391:110891. [PMID: 38278315 DOI: 10.1016/j.cbi.2024.110891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/14/2024] [Accepted: 01/23/2024] [Indexed: 01/28/2024]
Abstract
Tongue cancer has a very high incidence in China, and there is a need to develop new anti-tumour drugs against it. We synthesised 31 novel quinoline derivatives to test their anti-tumour activity. A compound referred to as "f25" was identified through screening for its high in vitro toxicity against an oral squamous carcinoma cell line (CAL-27). f25 exhibited significant cytotoxicity against CAL-27 cells (IC50 = 7.70 ± 0.58 μΜ). f25 also inhibited the migration and invasion of CAL-27 cells to a level comparable with that of the chemotherapy agent cisplatin. Moreover, f25 promoted the apoptosis of CAL-27 cells. Transcriptome sequencing and western blotting showed that the mechanism of action of f25 against CAL-27 cells involved the peroxisome proliferator-activated receptor (PPAR) signalling pathway. Specifically, f25 could bind to PPAR-α, PPAR-β, and PPAR-γ and increase their expression. In vivo experiments showed that treatment with f25 led to a reduction in tumour volume in nude mice without significant toxicity. Overall, this study highlights the potential of quinoline compounds (particularly f25) for the design and synthesis of anti-tumour drugs. It also underscores the importance of the PPAR signalling pathway as a target for potential cancer therapies.
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Affiliation(s)
- Tuo Liu
- Department of Stomatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lili Yang
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China
| | - Zeng Li
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, China.
| | - Ming Sun
- Department of Stomatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Na Lv
- Department of Stomatology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
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Ito S, Fuwa N, Nomura M, Ota S, Morishima T, Daimon T, Maeda Y, Ueda J, Tohnai I, Ii N, Miyati T. Drug concentration estimation using contrast-enhanced MRI in intra-arterial chemotherapy for head and neck cancers. Auris Nasus Larynx 2020; 48:496-501. [PMID: 33131964 DOI: 10.1016/j.anl.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/15/2020] [Accepted: 10/20/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In cases of head and neck cancer treated with intra-arterial chemotherapy, no objective indices are available for determining the distribution of anticancer drugs administered to multiple arteries. To establish such indices, noninvasive measurements of drug concentrations are required in the arterial perfusion area of each artery. In MRI, changes in 1/T1 (Δ1/T1) are correlated with the contrast agent concentration. We focused on these properties and investigated whether it is possible to estimate anticancer drug concentrations within tissue based on Δ1/T1. METHODS We employed the fast spin echo (FSE) sequence to determine optimum imaging parameters using a phantom. Subsequently, contrast agent was administered via the lingual and external carotid arteries for seven cases of tongue cancer. Δ1/T1 were then measured in tumor and nontumor tissues. The results of this study were compared with those of a previous study in which intratumor concentrations of anticancer agent were measured in excised specimens. RESULTS The optimum imaging parameters for the FSE was two repetition times (TR, 500 and 1000 ms). When compared with the external carotid artery administration, the lingual artery administration of contrast agent resulted in significantly higher Δ1/T1 in both tumor and nontumor tissues (2.13 and 2.62 times, respectively). The multiplying factor for the nontumor tissue and high homogeneity of the contrast agent concentration were reasonably consistent with the results of the previous study. CONCLUSION This method can be applied to estimating intratissue concentrations of intra-arterially administered anticancer drugs, thus possibly providing useful information in determining the distribution of anticancer drugs.
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Affiliation(s)
- Shintaro Ito
- Department of Medical Technology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan; Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan.
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Miwako Nomura
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Suguru Ota
- Department of Medical Technology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Takayuki Morishima
- Department of Medical Technology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8131, Japan
| | - Yoshikazu Maeda
- Proton Therapy Center, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, Fukui 910-8526, Japan
| | - Jun Ueda
- Department of Oral Maxillofacial Surgery, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Niigata, Niigata 951-8151, Japan
| | - Iwai Tohnai
- Department of Oral Health, Faculty of Health and Medical Sciences, Meikai University, 1 Meikai, Urayasu, Chiba 279-8550, Japan
| | - Noriko Ii
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Tosiaki Miyati
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
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A Novel External Carotid Arterial Sheath System for Intra-arterial Infusion Chemotherapy of Head and Neck Cancer. Cardiovasc Intervent Radiol 2017; 40:1099-1104. [PMID: 28357576 DOI: 10.1007/s00270-017-1635-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to describe a novel system for treating advanced head and neck cancer consisting of an external carotid arterial sheath (ECAS) and a microcatheter to inject drugs retrogradely into multiple feeding arteries through the superficial temporal artery (STA). MATERIALS AND METHODS Four consecutive patients with head and neck cancer that had more than one feeding artery were enrolled in this study. The ECAS was made of polyurethane and surface-coated with heparin resin to prevent thrombus formation, allowing it to remain in place for a prolonged period of time. The ECAS was inserted through the STA, and its tip was placed between the maxillary artery and facial artery. The tumor-feeding arteries were selected using a hooked-shaped microcatheter through the ECAS. RESULTS A total of 13 target arteries were selected in the four patients. The microcatheter inserted via the ECAS was used to catheterize ten arteries (five lingual arteries and five facial arteries). The remaining three lingual arteries were directly selected by the catheter without ECAS. All of the target arteries were able to be catheterized superselectively. The technical success rate was 100%. Vascular occlusion, which might have been caused by the ECAS, was observed in one patient. No neurologic toxicities occurred. CONCLUSION This ECAS system is a new approach for retrograde superselective intra-arterial chemotherapy that covers the entire tumor with anticancer drugs. It has the potential to increase the effectiveness of therapy for advanced head and neck cancer. LEVEL OF EVIDENCE Level 4, Case Series.
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Wu CF, Chang KP, Huang CJ, Chen CM, Chen CY, Steve Lin CL. Continuous intra-arterial chemotherapy for downstaging locally advanced oral commissure carcinoma. Head Neck 2013; 36:1027-33. [PMID: 23784874 DOI: 10.1002/hed.23408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 03/22/2013] [Accepted: 06/05/2013] [Indexed: 11/07/2022] Open
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.
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Affiliation(s)
- Chih-Fung Wu
- Department of Surgery, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Nakamura T, Fuwa N, Takayama K, Tomoda T, Takada A, Makita C, Shiomi M, Yokouchi JI, Watanabe K. A new method using MRI to delineate areas of head and neck cancer targeted by intra-arterial infusion via a superficial temporal artery. Oral Oncol 2011; 47:387-90. [DOI: 10.1016/j.oraloncology.2011.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Revised: 03/08/2011] [Accepted: 03/10/2011] [Indexed: 11/29/2022]
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Bertino G, Occhini A, Falco CE, Porta C, Corbella F, Colombo S, Balcet V, Morbini P, Zappoli F, Azzaretti A, Rodolico G, Tinelli C, Benazzo M. Concurrent intra-arterial carboplatin administration and radiation therapy for the treatment of advanced head and neck squamous cell carcinoma: short term results. BMC Cancer 2009; 9:313. [PMID: 19732449 PMCID: PMC2749058 DOI: 10.1186/1471-2407-9-313] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2008] [Accepted: 09/04/2009] [Indexed: 11/28/2022] Open
Abstract
Background The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin. Methods Fifty-six patients with primary head and neck squamous cell carcinoma received 4 cycles of intra-arterial carboplatin (350 mg/m2 per cycle every 2 weeks), with concurrent three-dimensional conformal radiation therapy. Results Two major and 4 minor complications were observed. Forty-five of the 56 patients (80%) completed the protocol, while 11 (20%) patients had to discontinue the intra-arterial infusions due to the occurrence of severe haematological toxicity, but were able to complete radiotherapy. Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall. After a median 23.55 months (range: 2 to 58 months) of follow-up, 40 patients (71%) are alive and disease-free, 1 (2%) is alive but affected by disease and 15 (27%) have died of the disease or other causes. Conclusion Intra-arterial carboplatin administration with concurrent three-dimensional conformal radiation therapy seems to be a promising alternative to RADPLAT in the treatment of advanced head and neck tumours. Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects.
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Affiliation(s)
- Giulia Bertino
- Department of Otolaryngology Head Neck Surgery, University of Pavia, IRCCS Policlinico S, Matteo Foundation, P.le Golgi 2, 27100 Pavia, Italy.
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Fuwa N, Kodaira T, Furutani K, Tachibana H, Nakamura T, Nakahara R, Tomoda T, Inokuti H, Daimon T. Arterial Chemoradiotherapy for Locally Advanced Tongue Cancer: Analysis of Retrospective Study of Therapeutic Results in 88 Patients. Int J Radiat Oncol Biol Phys 2008; 72:1090-100. [DOI: 10.1016/j.ijrobp.2008.02.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Revised: 02/12/2008] [Accepted: 02/13/2008] [Indexed: 12/18/2022]
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Treatment results of continuous intra-arterial CBDCA infusion chemotherapy in combination with radiation therapy for locally advanced tongue cancer. ACTA ACUST UNITED AC 2008; 105:714-9. [PMID: 18439857 DOI: 10.1016/j.tripleo.2007.11.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2007] [Revised: 10/24/2007] [Accepted: 11/21/2007] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The objective of this study was to improve the treatment results for locally advanced tongue cancer. A combination of radiotherapy with continuous intra-arterial therapy using CBDCA was used. STUDY DESIGN According to TNM staging (1997), 29 patients had stage III lesions and 11 patients had stage IV (M0) lesions. A catheter was inserted through the lingual artery in 26 patients, through the external carotid artery in 11 patients, and through the faciolingual trunk in 2 patients. CBDCA was continuously infused for 4 to 6 weeks. With IA chemotherapy, external irradiation (median dose: 46.8 Gy) was simultaneously performed, and 1 to 2 courses of systemic chemotherapy were performed in 19 patients before intra-arterial chemotherapy. RESULTS The 5-year local control rate was 65%. The 5-year OS rate was 39.5%. There were no clinically significant adverse side effects. CONCLUSION Continuous IA CBDCA and concurrent radiation therapy can be delivered safely with good efficacy for locally advanced carcinoma of the tongue.
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Fuwa N, Kodaira T, Furutani K, Tachibana H, Nakamura T. A new method of selective intra-arterial infusion therapy via the superficial temporal artery for head and neck cancer. ACTA ACUST UNITED AC 2008; 105:783-9. [PMID: 18206406 DOI: 10.1016/j.tripleo.2007.07.031] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Revised: 06/18/2007] [Accepted: 07/22/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE We proposed a new selective intra-arterial infusion method via the superficial temporal artery for preventing dislocation of the catheter. STUDY DESIGN This study included 92 patients who were treated by this combination therapy between May 1999 and December 2004. Primary tumor sites included the tongue in 73 patients, base of the tongue in 6 patients, floor of mouth in 4 patients, buccal mucosa in 4 patients, and other sites in 5 patients. Seventy-three patients had untreated lesions and 19 patients had recurrent lesions. Under fluoroscopy, a catheter was inserted into the target artery through the superficial temporal artery using a catheter exchange method. RESULTS In 76 (83%) of 92 patients, a catheter was successfully inserted into the target artery. In 4 patients, the catheter fell out of the selected artery during treatment. CONCLUSION This selective intra-arterial method will be an important modality for advanced tongue cancer.
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Affiliation(s)
- Nobukazu Fuwa
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
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Fujishiro Y, Nakao K, Watanabe K, Ebihara Y, Nakamura N, Mori H, Hayashi N, Asakage T. A new aspect of tri-modal therapy with superselective intra-arterial chemotherapy in maxillary sinus carcinoma. Acta Otolaryngol 2007:151-6. [PMID: 18340587 DOI: 10.1080/03655230701599842] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CONCLUSION This superselective intra-arterial intervention technique enabled us to administer a higher dose of cisplatinum to the local lesion with a lower incidence of adverse issues by use of neutralizer, compared with the conventional methods. OBJECTIVE A wide variety of modalities, including surgery, radiotherapy, and chemotherapy, alone or in combination, have been reported for the treatment of maxillary sinus cancer. However, there is still much controversy with regard to the optimum treatment to obtain better local control and acceptable preservation of shape and function. Since 2001, we have performed superselective intra-arterial infusion chemotherapy in combination with radiotherapy and surgery aiming at a higher local control rate. PATIENTS AND METHODS This was a review of prospective collected data. The therapeutic design consisted of weekly intra-arterial infusion of high dose CDDP with concomitant radiotherapy and planned surgery performed during chemo-radiation therapy. From June 2001 to January 2004, 14 patients with squamous cell carcinoma of maxillary sinus underwent this treatment procedure at the University of Tokyo Hospital. RESULTS The local response rate with this combined therapy was 85.7%. Overall survival rates at 1 and 2 years were 78.6% and 56.2%, respectively, with median follow-up of 25.5 months.
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Fuwa N, Kodaira T, Furutani K, Tachibana H, Nakamura T, Daimon T. Chemoradiation therapy using radiotherapy, systemic chemotherapy with 5-fluorouracil and nedaplatin, and intra-arterial infusion using carboplatin for locally advanced head and neck cancer – Phase II study. Oral Oncol 2007; 43:1014-20. [PMID: 17258494 DOI: 10.1016/j.oraloncology.2006.11.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2006] [Revised: 11/20/2006] [Accepted: 11/21/2006] [Indexed: 02/08/2023]
Abstract
To improve the treatment results for locally advanced head and neck cancer, chemoradiation therapy by radiotherapy, systemic chemotherapy with 5-fluorouracil (5FU) and nedaplatin (NDP), and intra-arterial therapy using carboplatin (CBDCA) was performed. Thirty-two patients were entered into the study between July 1997 and August 2002. According to the TNM staging (1997), 14 patients had stage III lesions, and 19 patients had stage IV (M0) lesions. Alternating chemoradiotherapy was performed by the following regimen. Initially, systemic chemotherapy was administered, followed by 4 weeks of radiotherapy (36Gy/20 fractions; wide field irradiation) starting 2 days after chemotherapy, a second course of systemic chemotherapy 2 days after radiotherapy, and a second course of a reduced field radiotherapy (30Gy/15 fractions) 2 days after chemotherapy. Arterial injection therapy was administered in the latter half of radiotherapy after the end of the second course of systemic chemotherapy. For systemic chemotherapy, 5FU at 3500mg/m(2)/120h was intravenously administered for 5 days (Days 1-5), and NDP at 120mg/m(2)/6h was administered on Day 6. An intra-arterial agent using CBDCA was continuously infused by a portable electrical pump for 4 (to 6) weeks. The total dose of CBDCA was AUC 6 as established by Calvert's formula. The 5-year local control rate was 59%. The 5-year overall survival rate was 51%. There were no clinically significant adverse effects. Chemoradiation therapy by radiotherapy, systemic chemotherapy, and intra-arterial chemotherapy for locally advanced head and neck cancer may be useful for improving treatment results.
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Affiliation(s)
- Nobukazu Fuwa
- Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
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Fuwa N, Nakamura T, Kodaira T. [Recent progress on radiotherapy for head and neck neoplasms]. NIHON JIBIINKOKA GAKKAI KAIHO 2007; 110:703-6. [PMID: 18198533 DOI: 10.3950/jibiinkoka.110.703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tsurumaru D, Kuroiwa T, Yabuuchi H, Hirata H, Higaki Y, Tomita K. Efficacy of Intra-Arterial Infusion Chemotherapy for Head and Neck Cancers Using Coaxial Catheter Technique: Initial Experience. Cardiovasc Intervent Radiol 2007; 30:207-11. [PMID: 17216381 DOI: 10.1007/s00270-005-0272-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The aim of this study was to evaluate the efficacy of intra-arterial infusion chemotherapy for head and neck cancers using a coaxial catheter technique: the superficial temporal artery (STA)-coaxial catheter method. Thirty-one patients (21 males and 10 females; 37-83 years of age) with squamous cell carcinoma of the head and neck (maxilla, 2; epipharynx, 4; mesopharynx, 8; oral floor, 4; tongue, 10; lower gingiva, 1; buccal mucosa, 2) were treated by intra-arterial infusion chemotherapy. Four patients were excluded from the tumor-response evaluation because of a previous operation or impossibility of treatment due to catheter trouble. Forty-eight sessions of catheterization were performed. A guiding catheter was inserted into the STA and a microcatheter was advanced into the tumor-feeding artery via the guiding catheter under angiographic guidance. When the location of the tumor or its feeding artery was uncertain on angiography, computed tomographic angiography was performed. The anticancer agent carboplatin (CBDCA) was continuously injected for 24 h through the microcatheter from a portable infusion pump attached to the patient's waist. The total administration dose was 300-1300 mg per body. External radiotherapy was administered during intra-arterial chemotherapy at a total dose of 21-70.5 Gy. The initial response was complete response in 15 patients, partial response in 7 patients, and no change in 5 patients; the overall response rate was 81.5% (22/27). Complication-related catheter maintenance was observed in 15 of 48 sessions of catheterization. Injury and dislocation of the microcatheter occurred 10 times in 7 patients. Catheter infection was observed three times in each of two patients, and catheter occlusion and vasculitis occurred in two patients. Intra-arterial infusion chemotherapy via the STA-coaxial catheter method could have potential as a favorable treatment for head and neck tumors.
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Affiliation(s)
- Daisuke Tsurumaru
- Department of Radiology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
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Nishioka T, Homma A, Furuta Y, Aoyama H, Suzuki F, Ohmori K, Asano T, Yoshida D, Shirato H, Fukuda S. A Novel Approach to Advanced Carcinoma of the Tongue: Cases Successfully Treated with Combination of Superselective Intra-Arterial Chemotherapy and External/High-Dose-Rate Interstitial Radiotherapy. Jpn J Clin Oncol 2006; 36:822-6. [PMID: 17060408 DOI: 10.1093/jjco/hyl111] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study sought to evaluate the efficacy and safety of a novel treatment regimen, intra-arterial cisplatin infusion plus external/high-dose-rate radiotherapy. METHODS Superselective intra-arterial infusion of cisplatin (100-120 mg) was performed concomitantly with external radiotherapy in four patients with locally advanced carcinoma of the tongue. A high-dose-rate brachytherapy boost was performed after combination therapy in all patients. Brachytherapy was performed after external radiotherapy, and the treatment schedule was twice daily, with a fraction of 600 cGy up to a total of 30-48 Gy. RESULTS All patients completed the therapy as scheduled. There were no vascular or neurological complications. Grade III acute radiation mucositis developed in all patients but this did not necessitate a treatment break. With a mean follow-up period of 35 months, loco-regional control was obtained for all patients. CONCLUSIONS The combination of weekly administration of intra-arterial cisplatin plus external/high-dose-rate radiotherapy seems effective for advanced carcinoma of the tongue.
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Affiliation(s)
- Takeshi Nishioka
- Laboratory of Radiation Therapy, Department of Health Science, School of Medicine, Hokkaido University, Sapporo, Japan.
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Rohde S, Turowski B, Berkefeld J, Kovács AF. CT-Based Evaluation of Tumor Volume After Intra-Arterial Chemotherapy of Locally Advanced Carcinoma of the Oral Cavity: Comparison with Clinical Remission Rates. Cardiovasc Intervent Radiol 2006; 30:85-91. [PMID: 17031736 DOI: 10.1007/s00270-005-0270-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To assess the volume of locally advanced tumors of the oral cavity and the oropharynx before and after intra-arterial (i.a.) chemotherapy by means of computed tomography and to compare these data with clinically determined treatment response of the same patient population. METHODS Eighty-eight patients with histologically proven, advanced carcinoma of the oral cavity and/or the oropharynx (local tumor stages T3/4) received neoadjuvant i.a. chemotherapy with cisplatin as part of a multimodal therapeutic regimen, comprising (1) local chemotherapy, (2) surgery, and (3) combined radio-chemotherapy. Three weeks after the intervention, residual disease was evaluated radiologically by measurement of the tumor volume and clinically by inspection and palpation of the primary tumor according to WHO criteria. RESULTS Comparison of treatment response according to radiological and clinical criteria respectively revealed complete remission in 5% vs. 8% (p < 0.05), partial remission in 30% vs. 31%, stable disease in 61% vs. 58%, and tumor progression in 5% vs. 2%. CONCLUSION Radiological volumetry and clinical evaluation found comparable response rates after local chemotherapy. However, in patients with good response after local treatment, volumetric measurement with CT may help to distinguish between partial and complete remission. Thus, radiological tumor volumetry provides precise and differentiated information about tumor response and should be used as an additional tool in treatment monitoring after local chemotherapy.
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Affiliation(s)
- Stefan Rohde
- Department of Neuroradiology, Ruprecht Karls University Medical School, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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Mitsudo K, Tohnai I, Fujimoto Y, Sawaki Y, Sugimura T, Nishiguchi H, Fukui T, Yamoto N, Ueda M. Leiomyosarcoma of the maxilla: Effective chemotherapy with docetaxel (DOC) and cisplatin (CDDP) using superselective intra-arterial infusion via superficial temporal artery. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ooe.2006.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Rohde S, Kovács AF, Berkefeld J, Turowski B. Reliability of CT-based tumor volumetry after intraarterial chemotherapy in patients with small carcinoma of the oral cavity and the oropharynx. Neuroradiology 2006; 48:415-21. [PMID: 16609894 DOI: 10.1007/s00234-006-0072-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2005] [Accepted: 01/17/2006] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The aim of the study was to evaluate the feasibility and consistency of CT-based tumor volumetry in patients with early carcinoma of the oral cavity and the oropharynx before and after intraarterial (IA) chemotherapy, comparing these data with clinical remission rates. METHODS Included in the study were 61 patients (mean age 59.3 years; 47 men) with histologically proven small carcinoma of the oral cavity or the oropharynx (local tumor stages T1/2). Patients received IA chemotherapy with high-dose cisplatin as part of a multimodal therapeutic regimen and underwent both clinical and radiological examination before and 4 weeks after local chemotherapy. RESULTS Clinical evaluation of tumor response was possible in all patients (61/61). Radiological assessment of tumor volume was feasible in 42 of 61 patients (69%), but failed in 19 (31%) due to the absence of deep tumoral spread, lack of contrast enhancement or severe dental artifacts. Patients in whom evaluation was possible according to volumetric and clinical criteria revealed comparable remission rates: overall response 54.8% versus 52.4%, stable disease 40.4% versus 47.6%, and tumor progression 4.8% versus 0.0%. CONCLUSION Because volume calculation was not feasible in approximately one-third of the patients, it cannot be recommended as a reliable indicator for treatment response in patients with small carcinoma of the oral cavity.
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Affiliation(s)
- Stefan Rohde
- Department of Neuroradiology, Ruprecht Karls-University Medical School, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
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Iguchi H, Kusuki M, Nakamura A, Kanazawa A, Hachiya K, Yamane H. Outcome of preoperative concurrent chemoradiotherapy and surgery for resectable lingual squamous cell carcinoma greater than 3cm: The possibility of less extensive surgery. Oral Oncol 2006; 42:391-7. [PMID: 16423554 DOI: 10.1016/j.oraloncology.2005.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2005] [Accepted: 09/20/2005] [Indexed: 11/30/2022]
Abstract
We present the outcome of treatment with preoperative concurrent chemoradiotherapy and surgery for resectable lingual squamous cell carcinoma more than 3 cm in its greatest dimension. Twenty patients were enrolled in this study between June 2001 and August 2004. Concurrent chemoradiotherapy included intraarterial pirarubicin (THP) (5 mg/day), intravenous continuous 5-FU, and radiation, usually followed by surgery. Complete response rate was 100%. Notably, 8 of 12 patients who underwent surgery exhibited pathologically complete response, though three patients developed recurrence or distant metastasis. The main adverse effects were mucositis (13/20) and leucopenia (9/20), both of which were acceptable. Although long-term results should be considered, our treatment method appears very useful for lingual squamous cell carcinoma greater than 3 cm, with a remarkably high rate of pathological local control and acceptable adverse events.
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Affiliation(s)
- Hiroyoshi Iguchi
- Department of Otolaryngology and Head and Neck Surgery, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
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19
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Robbins KT. Is high-dose intensity intraarterial cisplatin chemoradiotherapy for head and neck carcinoma feasible? Cancer 2005; 103:447-50. [PMID: 15633205 DOI: 10.1002/cncr.20807] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Teymoortash A, Bien S, Dalchow C, Sesterhenn A, Lippert BM, Werner JA. Selective High-Dose Intra-Arterial Cisplatin as Palliative Treatment for Incurable Head and Neck Cancer. Oncol Res Treat 2004; 27:547-51. [PMID: 15591713 DOI: 10.1159/000081336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of the present study was to evaluate the palliative effect of selective intra-arterial chemotherapy in progressive unresectable head and neck cancer previously treated with radiochemotherapy. PATIENTS AND METHODS 8 patients with advanced residual or recurrent squamous cell carcinoma of the head and neck were evaluated. These patients were included in the present study particularly because of progredient pain and recurrent bleedings due to tumor progression. In addition 6/8 patients suffered from unpleasant tumor-related smell. All patients received simultaneous infusions of cisplatin (150 mg/m2) intra-arterially to the tumor and sodium thiosulfate intravenously (9 g/m2) for systemic neutralization of cisplatin. The patients were treated by at most 4 cycles of selective intra-arterial chemotherapy via femoral approach. RESULTS Tumor-associated pain, occurrence of tumor bleeding and tumor-related smell were reduced after at least 2 cycles of intra-arterial chemotherapy in all patients. Clinical and radiological assessment of the primary tumor site revealed a partial response in 4 patients while 4 patients were classified as nonresponders. Intra-arterial cisplatin treatment was well tolerated. CONCLUSION Selective intra-arterial cisplatin therapy can be delivered safely for palliation of tumor-related symptoms of incurable head and neck cancer.
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Affiliation(s)
- A Teymoortash
- Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Germany.
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21
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Kovács AF. Intra-arterial induction high-dose chemotherapy with cisplatin for oral and oropharyngeal cancer: long-term results. Br J Cancer 2004; 90:1323-8. [PMID: 15054449 PMCID: PMC2409693 DOI: 10.1038/sj.bjc.6601674] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Intra-arterial (IA) chemotherapy for curative treatment of head and neck cancer experienced a revival in the last decade. Mainly, it was used in concurrent combination with radiation in organ-preserving settings. The modern method of transfemoral approach for catheterisation, superselective perfusion of the tumour-feeding vessel, and high-dose (150 mg m−2) administration of cisplatin with parallel systemic neutralisation with sodium thiosulphate (9 g m−2) made preoperative usage feasible. The present paper presents the results of a pilot study on a population of 52 patients with resectable stage 1–4 carcinomas of the oral cavity and the oropharynx, who were treated with one cycle of preoperative IA chemotherapy executed as mentioned above and radical surgery. There have been no interventional complications of IA chemotherapy, and acute side effects have been low. One tracheotomy had to be carried out due to swelling. The overall clinical local response has been 69%. There was no interference with surgery, which was carried out 3–4 weeks later. Pathological complete remission was assessed in 25%. The mean observation time was 3 years. A 3-year overall and disease-free survival was 82 and 69%, respectively, and at 5 years 77 and 59%, respectively. Survival results were compared to a treatment-dependent prognosis index for the same population. As a conclusion, it can be stated that IA high-dose chemotherapy with cisplatin and systemic neutralisation in a neoadjuvant setting should be considered a feasible, safe, and effective treatment modality for resectable oral and oropharyngeal cancer. The low toxicity of this local chemotherapy recommends usage especially in stage 1–2 patients. The potential of survival benefit as indicated by the comparison to the prognosis index should be controlled in a randomised study.
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Affiliation(s)
- A F Kovács
- Department of Maxillofacial Plastic Surgery, Johann Wolfgang Goethe-University Medical School, Frankfurt am Main, Germany.
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Barasch A, Epstein JB, Foong WC, Clayman L. Intralesional chemotherapy for head and neck carcinoma: a review of the literature. ACTA ACUST UNITED AC 2004; 97:307-11. [PMID: 15024351 DOI: 10.1016/j.tripleo.2003.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the last decade chemotherapy has gained widespread acceptance in the treatment of oral and pharyngeal cancer. Current standard treatment for advanced lesions consists of concomitant radiation and chemotherapy. This approach has provided marginal improvement of prognosis for Stage III-IV disease. Recent studies have explored the idea that locally delivered cytotoxic drugs could further improve prognosis in this patient population. We review this literature with the objective of popularizing these data and suggesting future directions for treatment and clinical research for head and neck cancer.
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Affiliation(s)
- Andrei Barasch
- Dept. of Diagnostic Sciences, University of Detroit Mercy School of Dentistry, MI 48219-0900, USA.
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Abstracts. Br Dent J 2002. [DOI: 10.1038/sj.bdj.4801474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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