Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis

Suzuki, Takayoshi; Sakashita, Tetsuya; Homma, Akihiro; Hatakeyama, Hyōe; Kano, Satoshi; Mizumachi, Takatsugu; Yoshida, Daisuke; Fujima, Noriyuki; Onimaru, Rikiya; Tsuchiya, Kunihiko; Yasuda, Kôichi; Shirato, Hiroki; Suzuki, Fumiyuki; Fukuda, Satoshi

doi:10.1007/s00405-016-3933-5

Cited by 7 publications

(3 citation statements)

References 24 publications

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“…Intra-arterial infusion for HNC treatment has also been performed with different infusion times, drug dosages and combinations but never with additional isolated thoracic perfusion. This technique increases the local exposure to drugs (Ye et al 2016; Suzuki et al 2016). …”

Section: Discussionmentioning

confidence: 99%

Short-term intra-arterial infusion chemotherapy for head and neck cancer patients maintaining quality of life

Aigner

Selak

2018

J Cancer Res Clin Oncol

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PurposeHead and neck cancer treatment achieves good locoregional tumor control rates while causing severe side effects. Therapy with chemotherapeutic drugs administered intravenously is limited because either the concentrations at the tumor site are too low or the total dosages are too high. The evaluation of a technique for short-term intra-arterial infusion chemotherapy is described herein.MethodsIn a retrospective study, we reviewed the medical records of 97 patients with head and neck cancers who received short-term intra-arterial infusion chemotherapy (62 patients previously untreated, 35 patients with prior radiotherapy). All patients refused further radiotherapy. Response rates, overall survival and adverse effects were the study endpoints. The blood supply of the tumors was controlled with indigocarmine blue infusion and staining of the tumor region.ResultsComplete or partial response was found in 67%, 52% and 63% of previously untreated patients and in 25%, 30% and 29%, respectively, of previously irradiated patients for staging groups I–III, IVA and IVB/C. Patients with T3/T4 tumors who were previously irradiated showed a median overall survival of 9 months, and those without pretreatment showed a median overall survival of 22.5 months. None of the patients required tube feeding. No new case of dysphagia, xerostomia, or functional speech and hearing loss was reported. Pain and clinical symptoms were reduced for all patient groups. Indigocarmine staining showed reduced tumor blood supply in previously irradiated regions but good blood supply in untreated regions.ConclusionsShort-term intra-arterial infusion chemotherapy achieves promising response rates and lacks severe adverse effects.Electronic supplementary materialThe online version of this article (10.1007/s00432-018-2784-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Short-term intra-arterial infusion chemotherapy for head and neck cancer patients maintaining quality of life

Aigner

Selak

2018

J Cancer Res Clin Oncol

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“…Egyéb lokalizációjú (non-nasopharyngealis) primer tumor esetén az N-statustól függ a sugármező kiegészítése a retropharyngealis régióra (2. táblázat) [12,13]. Az irodalom alapján a radioterápiával concomitansan végzett szuperszelektív intraarterialis kemoterápia biztató eredményt mutatott, az eljárás azonban nem terjedt el rutinszerűen [14].…”

Section: Kezelésunclassified

A retropharyngealis nyirokcsomóáttétek klinikai jelentősége

Révész

Oberna

Remenár

et al. 2021

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Összefoglaló. A retropharyngealis nyirokcsomóáttétek incidenciája a primer fej-nyaki daganat lokalizációjától függ. Leggyakrabban az előrehaladott vagy recidív nasopharynx-carcinomák esetén fordul elő, de III–IV. stádiumú oro- és hypopharynxtumorok esetén is megjelenhetnek. Non-nasopharyngealis primer tumoroknál a manifesztációjuk kedvezőtlen prognosztikai faktornak tekinthető, melynek hátterében a diagnosztikus nehézség miatti késői detektálás, a kifejezetten nehéz sebészi eltávolíthatóság, valamint az agresszív biológiai viselkedés állhat. Az esetismertetésünkben bemutatásra kerülő, 58 éves betegünknél bal oldali elülső szájfenéki primer tumort diagnosztizáltunk azonos oldali nyaki és retropharyngealis nyirokcsomó-metastasissal, mely a nemzetközi irodalom alapján extrém raritás, incidenciája kevesebb mint 1%. A retropharyngealis nyirokcsomók diagnosztikájában a lokalizáció miatt a képalkotóknak jut hangsúlyosabb szerep. Elhelyezkedésük nemcsak diagnosztikus, hanem sebésztechnikai kihívást is jelentenek az életfontosságú anatómiai képletek közelsége, illetve a szűk feltárási viszonyok miatt. Ilyenformán ezek a műtétek csak intenzív osztályos háttérrel és kellő jártassággal rendelkező centrumokban végezhetők. Az alapvetően rossz prognózist a korai diagnózis és a multimodális terápia kedvezően befolyásolja. Esetünkben a komplex kezeléssel (sebészi terápia és posztoperatív radiokemoterápia) sikerült lokoregionális tumormentességet elérni, és ezzel a teljes és a betegségmentes túlélési időt növelni. Orv Hetil. 2021; 162(25): 997–1003. Summary. The incidence of retropharyngeal lymph node metastasis depends on the localization of the primary head and neck cancer. Involved nodes are seen most commonly in cases of advanced or recurrent nasopharyngeal carcinoma, however, they might occur with stage III–IV oro- and hypopharyngeal tumours. The involvement of retropharyngeal lymph nodes has been associated with poor outcome of non-nasopharyngeal primary tumours, which might be explained by the delayed diagnosis, the difficult surgical procedure in the retropharyngeal space, and the aggressive nature of the disease. Here we present the case of a 58-year-old patient with an anterior oral cavity tumour on the left side with ipsilateral cervical lymph node and retropharyngeal lymph node metastases, which has been noted an extreme rarity in the literature with less than 1% incidence. Due to the localization of the retropharyngeal lymph nodes, the detection is based on imaging modalities. It represents a challenge for diagnosis and surgical treatment due to the close proximity of vital anatomical structures. Accordingly, these operations should only be performed in specialist surgical centres with intensive care units. The early diagnosis and the multimodality treatment might have a positive effect on the poor prognosis. In our case, we managed to achieve locoregional disease-free status with the complex treatment (surgical therapy and postoperative radiochemotherapy) and increase the overall and the disease-free survival. Orv Hetil. 2021; 162(25): 997–1003.

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“…Previous case reports involving these arteries have primarily focused on how to avoid neural complications[ 2 ]. The PT has also been discussed in patients with idiopathic epistaxis[ 3 ], benign or malignant neoplasm[ 3 , 4 ], trauma and iatrogenic damage[ 3 , 5 , 6 ], which is analogous to traumatic epistaxis. During iatrogenic procedures, the PT can be injured.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports

Yunaiyama¹,

Takara²,

Kobayashi³

et al. 2022

World J Clin Cases

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BACKGROUND The ascending pharyngeal artery (APhA) comprises the pharyngeal trunk (PT) and neuromeningeal trunk. The PT feeds the nasopharynx and adjacent tissue, which potentially connects with the sphenopalatine artery (SPA), branched from the internal maxillary artery (IMA). Due to its location deep inside the body, the PT is rarely injured by trauma. Here, we present two cases that underwent transcatheter arterial embolization (TAE) of the PT of the APhA due to trauma and iatrogenic procedure. CASE SUMMARY Case 1 is a 49-year-old Japanese woman who underwent transoral endoscopy under sedation for a medical check-up. The nasal airway was inserted as glossoptosis occurred during sedation. Bleeding from the nasopharynx was observed during the endoscopic procedure. As the bleeding continued, the patient was referred to our hospital for further treatment. Contrast-enhanced computed tomography (CT) demonstrated extravasation in the nasopharynx originating from the right Rosenmuller fossa. TAE was performed and the extravasation disappeared after embolization. Case 2 is a 28-year-old Japanese woman who fell from the sixth floor of a building and was transported to our hospital. Contrast-enhanced CT demonstrated a complex facial fracture accompanying extravasation in the left pterygopalatine fossa to the nasopharynx. Angiography demonstrated an irregular third portion of the IMA. As angiography after TAE of the IMA demonstrated extravasation from the PT of the APhA, additional TAE to the artery was performed. The bleeding stopped after the procedure. CONCLUSION Radiologists should be aware that the PT of the APhA can be a bleeding source, which has a potential connection with the SPA.

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Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis

Cited by 7 publications

References 24 publications

Short-term intra-arterial infusion chemotherapy for head and neck cancer patients maintaining quality of life

Short-term intra-arterial infusion chemotherapy for head and neck cancer patients maintaining quality of life

A retropharyngealis nyirokcsomóáttétek klinikai jelentősége

Transcatheter arterial embolization for traumatic injury to the pharyngeal branch of the ascending pharyngeal artery: Two case reports

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