Clinical outcomes of retrograde intra-arterial chemotherapy concurrent with radiotherapy for elderly oral squamous cell
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RESEARCH
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Clinical outcomes of retrograde intraarterial chemotherapy concurrent with radiotherapy for elderly oral squamous cell carcinoma patients aged over 80 years old Yuichiro Hayashi1, Kenji Mitsudo1*, Kaname Sakuma1, Masaki Iida1, Toshinori Iwai1, Hideyuki Nakashima1, Yoshiyuki Okamoto1, Toshiyuki Koizumi1, Senri Oguri1, Makoto Hirota1, Mitomu Kioi1, Izumi Koike2, Masaharu Hata2 and Iwai Tohnai1
Abstract Background: The aim of this retrospective observational study was to evaluate toxicities, overall survival, and locoregional control in elderly oral squamous cell carcinoma patients who had undergone retrograde intra-arterial chemotherapy combined with radiotherapy. Methods: Thirty-one elderly patients over 80 years old with oral squamous cell carcinoma were enrolled in present study. The treatment schedule consisted of intra- arterial chemotherapy (docetaxel, total 60 mg/m2; cisplatin, total 150 mg/m2) and daily concurrent radiotherapy (total, 60 Gy) for 6 weeks. Results: The median patient age was 82.5 years old (range, 80–88 years). Of the 31 patients, six (19%) had stage II, 6 (19%) had stage III, 17 (55%) had stage IVA, and 2 (6%) had stage IVB. The median follow-up period for all patients was 37 months (range, 7–86 months). The 3-year overall survival and locoregional control rates were 78% and 81%, respectively. The major acute grade 3 adverse events were oral mucositis in 22 (71%) patients, neutropenia in 16 (52%), and dermatitis in 11 (35%). With respect to late toxicities, 1 patient (3%) developed grade 3 osteoradionecrosis of the jaw. No grade 4 or higher toxicities were observed during the treatment and follow-up periods. Conclusions: Retrograde intra-arterial chemotherapy combined with radiotherapy was effective in improving overall survival and locoregional control even for elderly patients. Keywords: Intra-arterial chemotherapy, Elderly patient, Head and neck cancer, Oral cancer, Radiotherapy
Introduction The percentage of elderly patients with head and neck squamous cell carcinoma within the population is increasing as a result of the increased average age of the population. Almost 24% of patients with head and neck cancer are over the age of 70 years [1]. The majority of studies support appropriate surgical management of resectable head and neck malignancies (HNM) in elderly patients [2, 3]. With respect to the * Correspondence: [email protected] 1 Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan Full list of author information is available at the end of the article
postoperative quality of life (QOL) of HNM patients, there were no significant differences between elderly and younger patients [4]. However, especially in oral cancer patients, it is obvious that some functions, such as speech, mastication, and swallowing, were more affected by the surgical intervention. Several single-institutional studies have suggested reasonable rates of toxicities and excell
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