進行口腔癌の頸部リンパ節転移（N2, 3）に対する逆行性超選択的動注法を用いた温熱化学放射線療法
頸部の進展リンパ節転移 (N2, 3) を伴う頭頸部癌患者の予後は不良である. これはN3症例では頸部の周囲組織への浸潤により切除不能となることやN2, 3のような症例ではしばしば他臓器への遠隔転移を引き起こすことからである. そこでわれわれはこのようなN2, 3症例に対し, 逆行性超選択的動注法を用いた温熱化学放射線療法を治療戦略としている. 逆行性超選択的動注化学法は腫瘍内の抗癌剤濃度を上昇することができ, さらに連日の同時化学放射線併用療法が可能である. 外部加温による温熱療法は頸部リンパ節転移に対し有用で, 化学放射線療法との併用で相乗効果が期待できる. われわれは進行口腔癌のN2,...
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| Published in | Thermal Medicine Vol. 28; no. 2; pp. 23 - 28 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本ハイパーサーミア学会
2012
|
| Online Access | Get full text |
| ISSN | 1882-2576 1882-3750 |
| DOI | 10.3191/thermalmed.28.23 |
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| Abstract | 頸部の進展リンパ節転移 (N2, 3) を伴う頭頸部癌患者の予後は不良である. これはN3症例では頸部の周囲組織への浸潤により切除不能となることやN2, 3のような症例ではしばしば他臓器への遠隔転移を引き起こすことからである. そこでわれわれはこのようなN2, 3症例に対し, 逆行性超選択的動注法を用いた温熱化学放射線療法を治療戦略としている. 逆行性超選択的動注化学法は腫瘍内の抗癌剤濃度を上昇することができ, さらに連日の同時化学放射線併用療法が可能である. 外部加温による温熱療法は頸部リンパ節転移に対し有用で, 化学放射線療法との併用で相乗効果が期待できる. われわれは進行口腔癌のN2, 3症例に対し, 逆行性超選択的動注法を用いた温熱化学放射線療法を行ったところ, 良好な病理組織学的および頸部・原発の制御が得られた. |
|---|---|
| AbstractList | 頸部の進展リンパ節転移 (N2, 3) を伴う頭頸部癌患者の予後は不良である. これはN3症例では頸部の周囲組織への浸潤により切除不能となることやN2, 3のような症例ではしばしば他臓器への遠隔転移を引き起こすことからである. そこでわれわれはこのようなN2, 3症例に対し, 逆行性超選択的動注法を用いた温熱化学放射線療法を治療戦略としている. 逆行性超選択的動注化学法は腫瘍内の抗癌剤濃度を上昇することができ, さらに連日の同時化学放射線併用療法が可能である. 外部加温による温熱療法は頸部リンパ節転移に対し有用で, 化学放射線療法との併用で相乗効果が期待できる. われわれは進行口腔癌のN2, 3症例に対し, 逆行性超選択的動注法を用いた温熱化学放射線療法を行ったところ, 良好な病理組織学的および頸部・原発の制御が得られた. |
| Author | 飯田, 昌樹 藤内, 祝 光永, 幸代 小泉, 敏之 光藤, 健司 |
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| References | 7) Tohnai I., Hayashi Y., Mitsudo K., Shigetomi T., Ueda M., Ishigaki T. : Prognostic evaluation of preoperative thermochemoradiotherapy for N3 cervical lymph node metastases of oral cancer. Oncology, 62 : 234-240, 2002. 2) Fuwa N., Ito Y., Kato E. : Superselective intra-arterial continuous chemotherapy with CBDCA for advanced head and neck cancer. Jpn J Head Neck Cancer, 22 : 139-143, 1996. (Japanese 16) Carvalho A.L., Kowalski L.P., Agra I.G., Pontes E., Campos O.D., Pellizzon A.A. : Treatment results on advanced neck metastasis (N3) from head and neck squamous carcinoma. Otolaryngol Head Neck Surg, 132 : 862-868, 2005. 17) Merino O.R., Lindberg R.D., Fletcher G.H. : An analysis of distant metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer, 40 : 145-151, 1977. 9) Mitsunaga S., Mitsudo K., Iwai T., Baba J., Shibasaki M., Ohara Y., Hirota M., Matsui Y., Tohnai I. : A case with carcinoma of the upper gingiva and N3 treated successfully with retrograde superselective intra-arterial chemoradiotherapy combined with hyperthermia. J Jpn Soc Oral Tumor, 22 : 157-163, 2010. (Japanese 14) Forastiere A.A. : Cisplatin and radiotherapy in the management of locally advanced head and neck cancer. Int J Radiat Oncol Biol Phys, 27 : 465-470, 1993. 8) Mitsudo K., Koizum T., Iida M., Iwai T., Oguri S., Yamamoto N., Itoh Y., Kioi M., Hirota M., Tohnai I. : Thermochemoradiotherapy using superselective intra-arterial infusion via superficial temporal and occipital arteries for oral cancer with N3 cervical lymph node metastases. Int J Radiat Oncol Biol Phys, in press. 12) Kampinga H.H., Dikomey E. : Hyperthermic radiosensitization : Mode of action and clinical relevance. Int J Radiat Biol, 77 : 399-408, 2001. 18) Ballonoff A., Raben D., Rusthoven K.E., Bassetti M., Kane M., Song J.I., Chen C. : Outcomes of patients with N3 neck nodes treated with chemoradiation. Laryngoscope, 118 : 995-998, 2008. 10) Iwai T., Mitsudo K., Fukui T., Baba J., Uezono M., Ohhara Y., Shoji S., Mitsunaga S., Adachi M., Watanuki K., Ohta S., Chikumaru H., Hirota M., Matsui Y., Tohnai I. : Catheter placement via the occipital artery to achieve superselective intra-arterial chemotherapy for oral cancer. Jpn J Head Neck Cancer, 33 : 508-512, 2008. (Japanese 19) Schechter M., Stowe S.M., Moroson H. : Effects of hyperthermia on primary and metastatic tumor growth and host immune response in rats. Cancer Res, 38 : 498-502, 1978. 6) Itazawa T., Watai K., Kurihara S., Inoue T. : Hyperthermia combined with chemoradiotherapy for treatment of locally advanced head and neck cancer with bulky lymph node metastasis. Thermal Med, 22 : 151-158, 2006. 1) Hattori T., Hirano T., Toyoda S., Nakagawa T., Yamaguchi N. : Superselective continuous intra-arterial infusion therapy via superficial temporal artery for head and neck tumors. Jpn J Radiat, 45 : 1056-1058, 1985. (Japanese 20) Knippertz I., Stein M., Dorrie J., Schaft N., Muller I., Deinzer A., Steinkasserer A., Nettelbeck D.M. : Mild hyperthermia enhances human monocyte-derived dendritic cell functions and offers potential for applications in vaccination strategies. Int J Hyperthermia, 27 : 591-603, 2011. 3) Tohnai I., Fuwa N., Hayashi Y., Kaneko R., Tomaru Y., Hibino Y., Ueda M. : New superselective intra-arterial infusion via superficial temporal artery for cancer of the tongue and tumour tissue platinum concentration after carboplatin (CBDCA) infusion. Oral Oncol, 34 : 387-390, 1998. 11) Lepock J.R., Cheng K.H., AL-Qysi H., Kruuv J. : Thermotropic lipid and protein transitions in Chinese hamster lung cell membranes : Relationship to hyperthermic cell killing. Can J Biochem Cell Biol, 61 : 421-427, 1983. 15) Valdagni R., Amichetti M. : Report of long-term follow-up in a randomized trial comparing radiation therapy and radiation therapy plus hyperthermia to metastatic lymphnodes in stage IV head and neck patients. Int J Radiat Oncol Biol Phys, 28 : 163-169, 1994. 13) Hahn G.M., Shiu E.C. : Adaptation to low pH modifies thermal and thermo-chemical responses of mammalian cells. Int J Hyperthermia, 2 : 379-387, 1986. 4) Mitsudo K., Shigetomi T., Fujimoto Y., Nishiguchi H., Yamamoto N., Furue H., Ueda M., Itoh Y., Fuwa N., Tohnai I. : Organ preservation with daily concurrent chemoradiotherapy using superselective intra-arterial infusion via a superficial temporal artery for T3 and T4 head and neck cancer. Int J Radiat Oncol Biol Phys, 79 : 1428-1435, 2011. 5) Jacobs C., Makuch R. : Efficacy of adjuvant chemotherapy for patients with resectable head and neck cancer : A subset analysis of the head and neck contracts program. J Clin Oncol, 8 : 838-847, 1990. |
| References_xml | – reference: 3) Tohnai I., Fuwa N., Hayashi Y., Kaneko R., Tomaru Y., Hibino Y., Ueda M. : New superselective intra-arterial infusion via superficial temporal artery for cancer of the tongue and tumour tissue platinum concentration after carboplatin (CBDCA) infusion. Oral Oncol, 34 : 387-390, 1998. – reference: 1) Hattori T., Hirano T., Toyoda S., Nakagawa T., Yamaguchi N. : Superselective continuous intra-arterial infusion therapy via superficial temporal artery for head and neck tumors. Jpn J Radiat, 45 : 1056-1058, 1985. (Japanese) – reference: 4) Mitsudo K., Shigetomi T., Fujimoto Y., Nishiguchi H., Yamamoto N., Furue H., Ueda M., Itoh Y., Fuwa N., Tohnai I. : Organ preservation with daily concurrent chemoradiotherapy using superselective intra-arterial infusion via a superficial temporal artery for T3 and T4 head and neck cancer. Int J Radiat Oncol Biol Phys, 79 : 1428-1435, 2011. – reference: 8) Mitsudo K., Koizum T., Iida M., Iwai T., Oguri S., Yamamoto N., Itoh Y., Kioi M., Hirota M., Tohnai I. : Thermochemoradiotherapy using superselective intra-arterial infusion via superficial temporal and occipital arteries for oral cancer with N3 cervical lymph node metastases. Int J Radiat Oncol Biol Phys, in press. – reference: 2) Fuwa N., Ito Y., Kato E. : Superselective intra-arterial continuous chemotherapy with CBDCA for advanced head and neck cancer. Jpn J Head Neck Cancer, 22 : 139-143, 1996. (Japanese) – reference: 6) Itazawa T., Watai K., Kurihara S., Inoue T. : Hyperthermia combined with chemoradiotherapy for treatment of locally advanced head and neck cancer with bulky lymph node metastasis. Thermal Med, 22 : 151-158, 2006. – reference: 7) Tohnai I., Hayashi Y., Mitsudo K., Shigetomi T., Ueda M., Ishigaki T. : Prognostic evaluation of preoperative thermochemoradiotherapy for N3 cervical lymph node metastases of oral cancer. Oncology, 62 : 234-240, 2002. – reference: 14) Forastiere A.A. : Cisplatin and radiotherapy in the management of locally advanced head and neck cancer. Int J Radiat Oncol Biol Phys, 27 : 465-470, 1993. – reference: 17) Merino O.R., Lindberg R.D., Fletcher G.H. : An analysis of distant metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer, 40 : 145-151, 1977. – reference: 13) Hahn G.M., Shiu E.C. : Adaptation to low pH modifies thermal and thermo-chemical responses of mammalian cells. Int J Hyperthermia, 2 : 379-387, 1986. – reference: 16) Carvalho A.L., Kowalski L.P., Agra I.G., Pontes E., Campos O.D., Pellizzon A.A. : Treatment results on advanced neck metastasis (N3) from head and neck squamous carcinoma. Otolaryngol Head Neck Surg, 132 : 862-868, 2005. – reference: 19) Schechter M., Stowe S.M., Moroson H. : Effects of hyperthermia on primary and metastatic tumor growth and host immune response in rats. Cancer Res, 38 : 498-502, 1978. – reference: 20) Knippertz I., Stein M., Dorrie J., Schaft N., Muller I., Deinzer A., Steinkasserer A., Nettelbeck D.M. : Mild hyperthermia enhances human monocyte-derived dendritic cell functions and offers potential for applications in vaccination strategies. Int J Hyperthermia, 27 : 591-603, 2011. – reference: 18) Ballonoff A., Raben D., Rusthoven K.E., Bassetti M., Kane M., Song J.I., Chen C. : Outcomes of patients with N3 neck nodes treated with chemoradiation. Laryngoscope, 118 : 995-998, 2008. – reference: 12) Kampinga H.H., Dikomey E. : Hyperthermic radiosensitization : Mode of action and clinical relevance. Int J Radiat Biol, 77 : 399-408, 2001. – reference: 5) Jacobs C., Makuch R. : Efficacy of adjuvant chemotherapy for patients with resectable head and neck cancer : A subset analysis of the head and neck contracts program. J Clin Oncol, 8 : 838-847, 1990. – reference: 9) Mitsunaga S., Mitsudo K., Iwai T., Baba J., Shibasaki M., Ohara Y., Hirota M., Matsui Y., Tohnai I. : A case with carcinoma of the upper gingiva and N3 treated successfully with retrograde superselective intra-arterial chemoradiotherapy combined with hyperthermia. J Jpn Soc Oral Tumor, 22 : 157-163, 2010. (Japanese) – reference: 10) Iwai T., Mitsudo K., Fukui T., Baba J., Uezono M., Ohhara Y., Shoji S., Mitsunaga S., Adachi M., Watanuki K., Ohta S., Chikumaru H., Hirota M., Matsui Y., Tohnai I. : Catheter placement via the occipital artery to achieve superselective intra-arterial chemotherapy for oral cancer. Jpn J Head Neck Cancer, 33 : 508-512, 2008. (Japanese) – reference: 11) Lepock J.R., Cheng K.H., AL-Qysi H., Kruuv J. : Thermotropic lipid and protein transitions in Chinese hamster lung cell membranes : Relationship to hyperthermic cell killing. Can J Biochem Cell Biol, 61 : 421-427, 1983. – reference: 15) Valdagni R., Amichetti M. : Report of long-term follow-up in a randomized trial comparing radiation therapy and radiation therapy plus hyperthermia to metastatic lymphnodes in stage IV head and neck patients. Int J Radiat Oncol Biol Phys, 28 : 163-169, 1994. |
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| Title | 進行口腔癌の頸部リンパ節転移（N2, 3）に対する逆行性超選択的動注法を用いた温熱化学放射線療法 |
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