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Preoperative intra-arterial chemotherapy with docetaxel,cisplatin, and peplomycin combined with intravenous chemotherapy using 5-fluorouracil for oral squamous cell carcinoma
Affiliation:1. Department of Dentistry and Oral Surgery, Fukushima Medical University, School of Medicine, Fukushima, Japan;2. Department of Dentistry and Oral Surgery, Tsuruoka Municipal Shonai Hospital, Tsuruoka, Japan;3. Department of Dentistry, Kashima Hospital, Ibaraki, Japan;4. Department of Head and Neck, Facial Surgery, Ohara General Hospital, Fukushima, Japan;1. Department of Head and Neck Surgical Oncology, VPS Lakeshore Hospital, Cochin, Kerala, India;2. Department of Plastic Surgery, VPS Lakeshore Hospital, Cochin, Kerala, India;1. Institute of Maxillofacial Surgery, Teknon Medical Centre Barcelona, Barcelona, Spain;2. Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain;1. Department of Neurosurgery, Medical University of Vienna, Vienna, Austria;2. Institute of Science and Technology Austria, Klosterneuburg, Austria;3. Institute for Simulation and Graphics, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany;4. Department of Radiology, Medical University of Vienna, Vienna, Austria;5. Centre for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria;6. Department of Neurosurgery, Neuroscience Institute, Qatar;7. Department of Oral and Maxillofacial Surgery Medical University of Vienna, Vienna, Austria;1. Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China;2. Department of Oral and Maxillofacial Surgery, Mother and Childhood Hospital, Ministry of Health, Ibb City, Yemen;1. Department of Otolaryngology – Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Center/University Health Network, University of Toronto, Toronto, Canada;2. Department of Pathology, University Health Network, Toronto, Canada;3. Department of Biostatistics, Princess Margaret Cancer Center, Toronto, Canada;4. Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, Canada;5. Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, Toronto, Canada
Abstract:The objectives of this study were to evaluate survival in 141 patients with stage II–IV oral squamous cell carcinoma (OSCC) treated with preoperative intra-arterial chemotherapy with docetaxel, cisplatin, and peplomycin combined with intravenous chemotherapy using 5-fluorouracil (IADCPIVF) via the superficial temporal artery, and to clarify the prognostic factors. The study population included 59 patients with stage II OSCC, 34 with stage III, and 48 with stage IV. After IADCPIVF, 139 patients underwent surgery; minimally invasive surgeries (MIS) including excisional biopsy were performed on 96 patients with a remarkably good response to IADCPIVF. The primary tumour response rate was 99.3% (complete response rate 56.7%, good partial response rate 17.0%, fair partial response rate 25.5%). Additionally, there were no serious adverse events associated with IADCPIVF. The 5-year overall survival rate was 74.6% (stage II 83.6%, stage III 72.7%, stage IV 64.8%). In the multivariate analysis of survival, T classification and clinical tumour response were significant prognostic factors. Eight (8.3%) of the patients who received MIS had primary recurrence and six were salvaged. In conclusion, IADCPIVF is safe and efficacious for treating OSCC, and MIS could reduce the extent of primary tumour resection in the case of a remarkably good response.
Keywords:oral cancer  intra-arterial chemotherapy  docetaxel  cisplatin  peplomycin  5-fluorouracil
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