Retrograde superselective intra-arterial chemoradiotherapy combined with hyperthermia and cetuximab for carcinoma of the buccal mucosa with N3 lymph node metastasis: a case report

• Published in: Oral radiology Vol. 35; no. 1; pp. 77 - 83
• Main Authors: Sakuma, Kaname, Koizumi, Toshiyuki, Mitsudo, Kenji, Ueda, Jun, Hayashi, Yuichiro, Iwai, Toshinori, Hirota, Makoto, Kioi, Mitomu, Yoshii, Haruka, Kaizu, Hisashi, Hata, Masaharu, Tanaka, Akira, Tohnai, Iwai
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.01.2019; Springer Nature B.V
• Subjects: Biopsy; Buccal mucosa; Case Report; Case reports; Chemoradiotherapy; Chemotherapy; Cisplatin; Dentistry; Fever; Hyperthermia; Imaging; Immunotherapy; Lymph; Lymph nodes; Lymphatic system; Mastectomy; Medicine; Metastases; Metastasis; Monoclonal antibodies; Neck; Oral and Maxillofacial Surgery; Oral cancer; Radiation therapy; Radiology; Reconstructive surgery; Skin; Squamous cell carcinoma; Surgery; Targeted cancer therapy; Intra-arterial chemoradiotherapy; Oral cancer; Cetuximab; N3 cervical lymph node metastasis; Hyperthermia
• ISSN: 0911-6028; 1613-9674; 1613-9674
• DOI: 10.1007/s11282-018-0319-y

We herein report a case of squamous cell carcinoma of the buccal mucosa with N3 cervical lymph node metastasis in a 63-year-old man. The patient was treated with combination therapy comprising radiotherapy (2 Gy/day, total of 70 Gy), superselective intra-arterial chemotherapy via a superficial temporal artery (docetaxel, total of 70 mg/m 2 and cisplatin, total of 175 mg/m 2 ), cetuximab (initial dose of 400 mg/m 2 with subsequent weekly doses of 250 mg/m 2 intravenously), and four sessions of hyperthermia for cervical lymph node metastases. The patient responded well to the therapy, with a complete response of the primary tumor. Radical neck dissection was performed with reconstructive surgery, including resection of the overlying skin. A pathologic complete response was achieved for the N3 and all other cervical lymph node metastases. The patient showed no evidence of recurrence in the 3 years following treatment. Based on the findings in the present case, the use of retrograde superselective intra-arterial chemoradiotherapy combined with hyperthermia and cetuximab seems to be a promising modality for patients with N3 cervical lymph node metastasis of oral cancer.