FIFTEEN COURSES OF SELECTIVE INTRA-ARTERIAL CHEMOTHERAPY FOR RELAPSE OF CANCER OF THE ORAL MUCOSA IN ONE PATIENT

Objective. To show the possibility of repeated (up to 15 times) application of intra-arterial chemotherapy (IACT) for
the recurrence of squamous cell carcinoma of the oral cavity two years after standard chemoradiotherapy (SSRT).
Material and methods. At the patient, male 57 years old, with the cancer of a mucosa of a bottom of an oral cavity
st. II T2N0M0, SSRT was performed: Radiation 2 Gy x 1 times a day, 5 days a week, up to a total dose of 68 Gy; one
induction and two concurrent cycles of systemic chemotherapy (SCT) according to PF scheme (Cisplatin 150 mg in 1 day and
2250 mg of 5-fluorouracil on days 1, 2, 3, 4). A full clinical response was received. After 2 years, a relapse occurred. The use
of SCT (PF, as well as TPF) with palliative purpose did not result. In connection with the rapid progression of the disease,
a decision was made about the use of IACT.
Results. After 2 courses of IACT in both external carotid arteries (Cisplatin 150 mg and 5-fluorourocyl 500 mg), cicatrization
of the tumor ulcer, improvement of the lability of the tongue, complete refusal of analgesics were noted. Re-irradiation
was started up to 42 Gy. Six more cycles of IACT were performed super selectively in both facial arteries (docetaxel 80 mg,
cisplatin 100 mg). Stabilization for 17 months was received. Then with the palliation, another 7 cycles of selective IACT were
performed, which allowed to prolongation the life of the patient for a period of 32 months after the detection of a relapse.
Conclusion. It is possible long-term application of IACT in the recurrence of squamous cell carcinomas after chemoradiotherapy.
The selective IACT allows not only to loco-regional control, but it could be a «bridge» to re-irradiation therapy.
Even after a recurrence, the IACT can be successfully applied with a palliative purpose.