Clinical trial of chemotherapy by superselective intra-arterial infusion of nedaplatin combined with radiotherapy for advanced oral cancer

摘要

Nedaplatin (CDGP) is designed to further improve the anti-tumor effect and to reduce adverse effects of cisplatin (CDDP), such as renal toxicity. We previously reported a combination therapy of superselective intraarterial CDGP infusion, and radiation therapy could be delivered safely with good efficacy for locoregional management of oral cancer. However, both the clinical and pathological response decreased with tumor progression. This study was performed to assess the feasibility of a new chemotherapy regimen by superselective intraarterial infusion of CDGP in patients with advanced oral carcinomas. This regimen is under way in which chemotherapy with 5-FU 500 mg/day on days 1 to 5 and superselective intra-arterial infusion of CDGP on day 6 combined with radiation therapy is being evaluated for locally advanced oral cancer. Eight patients were treated with this regimen. After evaluation of the response, patients underwent surgery as a therapeutic procedure. Both the complete and partial response rates were achieved in each 3 patients (37.5%), respectively. Histological effects classified according to Oboshi-Shimosato's criteria were grade IVa in 2 patients, grade III in 1, grade IIb in 1, grade IIa in 3, and grade I in 1. All patients were free from renal dysfunction, which is one of the adverse effects of CDDP. Moreover, most toxicity was relatively mild in all patients.