Efficacy of concurrent intra-arterial chemotherapy and radiotherapy for late-stage squamous cell carcinoma of the temporal bone

Abstract

Advanced squamous cell carcinoma（SCC）of the temporal bone carries a poor prognosis because of its location in the cranial base and proximity to the great vessels, which pose anatomical barriers to en―bloc resection with an adequate safety margin. In addition, tumors that invade bone are also known to be resistant to radiotherapy. We analyzed the disease―free survival, adverse events, and cisplatin dosage in 14 patients who received intra―arterial chemotherapy combined with radiotherapy. The estimated cumulative survival rate was 64.3%. Of the four patients with cervical lymph node metastasis, two died as a result of lung metastasis, and one became cancer―bearing including lung metastasis. Two patients developed facial palsy, but recovered completely from it after steroid administration. No other serious adverse effects, such as osteonecrosis, occurred in any of the cases. In all cases, treatment could be continued without interruption, and none of the patients discontinued treatment. These results suggest that intra―arterial chemotherapy combined with radiotherapy is a good treatment alternative for patients with extensive local progression and no lymph node metastasis, and also for those who have difficulty in completing systemic chemotherapy. This therapy should be performed in facilities with personnel skilled in angiographic procedures.