Long-term results of comprehensive treatment of patients with locally advanced tongue cancer using selective intraarterial and systemic polychemotherapy
- Authors: Sedakov I.E.1, Polzikov G.N.2, Koktyshev I.V.1
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Affiliations:
- M. Gorkiy Donetsk State Medical University
- G.V. Bondar Republican Cancer Center
- Issue: Vol 10, No 1 (2025)
- Pages: 50-55
- Section: Oncology and radiotherapy
- URL: https://journal-vniispk.ru/2500-1388/article/view/286965
- DOI: https://doi.org/10.35693/SIM642579
- ID: 286965
Cite item
Abstract
Aim – to evaluate the long-term results of complex treatment of patients with locally advanced tongue cancer (T3-4N0-3M0) using modified selective intra-arterial polychemotherapy and systemic polychemotherapy.
Material and methods. Depending on the polychemotherapy regimen, taking into account the designated classifications, all patients were divided into two groups. The study group included 51 patients who received intra-arterial polychemotherapy according to the PF regimen, followed by radiation therapy. The control group included 50 patients who received intravenous polychemotherapy according to the PF regimen, followed by radiation therapy. With positive dynamics in the study group and the control group (partial tumor regression), surgical treatment was performed in the amount of hemiglossectomy. In case of complete tumor regression, the 2nd stage of the telegammatherapy course on the tongue was performed up to a total dose of 60 Gy. In case of oncological process stabilization, the 2nd stage of the telegammatherapy course on the tongue was performed up to a total dose of 60 Gy, followed by palliative courses of systemic polychemotherapy. In case of disease progression, palliative courses of systemic polychemotherapy were performed.
Results. Three-year survival in the study group was 80.1±6%, while in the control group it was 56.6±7% (p<0.05). Five-year survival among patients in the study group was 39.4±7%, while in the control group it was 2 times lower – 18.9±5% (p<0.05). About 7% of patients in the study group survived for more than 8 years.
Conclusions. The treatment regimen we developed for patients with locally advanced tongue cancer, which includes selective intra-arterial polychemotherapy followed by radiation therapy to the primary tumor and areas of regional metastasis, increased the median survival, three- and five-year survival.
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##article.viewOnOriginalSite##About the authors
Igor E. Sedakov
M. Gorkiy Donetsk State Medical University
Email: sedakov.i.e@gmail.com
ORCID iD: 0000-0003-0500-3940
MD, Dr. Sci. (Medicine), Head of the Department of Oncology and Radiology named after Academician G.V. Bondar
Russian Federation, DonetskGennadii N. Polzikov
G.V. Bondar Republican Cancer Center
Author for correspondence.
Email: crawl03081987@gmail.com
oncologist of the oncological surgical department No. 1
Russian Federation, DonetskIgor V. Koktyshev
M. Gorkiy Donetsk State Medical University
Email: Koktishev@gmail.com
Cand. Sci. (Medicine), Associate Professor of the Department of Public Health, Healthcare, Healthcare Economics
Russian Federation, DonetskReferences
- Nomura M, Fuwa N, Ito S, et al. Initial Experience of Intra-Arterial Chemotherapy Using a Novel External Carotid Arterial Sheath System Combined with Radiotherapy and Systemic Chemotherapy for Locally Advanced Tongue Cancer. Cancers (Basel). 2022;14(22):5529. doi: 10.3390/cancers14225529
- Kaprin AD, Starinsky VV, Shakhzadova AO. State of oncological care for the population of Russia in 2023. M., 2024:10-31. (In Russ.). [Каприн А.Д., Старинский В.В., Шахзадова А.О. Состояние онкологической помощи населению России в 2023 году. М.,2024:10-31].
- Hussein AA, Helder MN, de Visscher JG, et al. Global incidence of oral and oropharynx cancer in patients younger than 45 years versus older patients: A systematic review. Eur J Cancer. 2017;82:115-127. doi: 10.1016/j.ejca.2017.05.026
- Sarode G, Maniyar N, Sarode SC, et al. Epidemiologic aspects of oral cancer. Dis Mon. 2020;66(12):100988. doi: 10.1016/j.disamonth.2020.100988
- Baba A, Hashimoto K, Kayama R, et al. Radiological approach for the newly incorporated T staging factor, depth of invasion (DOI), of the oral tongue cancer in the 8th edition of American Joint Committee on Cancer (AJCC) staging manual: assessment of the necessity for elective neck dissection. Jpn J Radiol. 2020;38(9):821-832. doi: 10.1007/s11604-020-00982-w
- Huang CC, Yang TL, Tseng WH, et al. An alternative surgical technique for advanced tongue/tongue base cancer without free flap reconstruction. J Formos Med Assoc. 2022;121(12):2626-2632. doi: 10.1016/j.jfma.2022.07.007
- Keshava A, Gugwad S, Baad R, Patel R. Gingival squamous cell carcinoma mimicking as a desquamative lesion. J Indian Soc Periodontol. 2016;20:75-78. doi: 10.4103/0972-124X.164765
- Siu A, Landon K, Ramos D. Differential diagnosis and management of oralulcers. Semin Cutan Med Surg. 2015;34:171-177. doi: 10.12788/j.sder.2015.0170
- Sokolovska MV. The effectiveness of tumor radiosensitization with low doses of ionizing radiation in radiation treatment of stage II–III oral mucosa cancer. Ukrainian Journal of Radiology. 2015;23(2):151-153. (In Ukrainian). [Соколовська М.В. Ефективність радіосенсибілізації пухлини малими дозами іонізуюч ого випромінення при променевомулікуванні раку слизової оболонки ротової порожнини II–III стадій. Український радіологічний журнал. 2015;23(2):151-153].
- Sher DJ, Yan J, Day A, et al. Comparative effectiveness of primary radiotherapy versus surgery in elderly patients with locally advanced oropharyngeal squamous cell carcinoma. Oral Oncol. 2019;88:18-26.doi: 10.1016/j.oraloncology.2018.11.004
- Lim SH, Sun JM, Hong J, et al. Induction chemotherapy followed by concurrent chemoradiotherapy versus CCRT for locally advanced hypopharynx and base of tongue cancer. Korean J Intern Med. 2021;36(1):217-224. doi: 10.3904/kjim.2019.161
- Harsh KK, Maharia SR, Nirban RK, et al. Metronomic palliative chemotherapy in locally advanced, recurrent and metastatic head-and-neck cancer: A single-arm, retrospective study of a regional cancer center of North India (Asia). J Cancer Res Ther. 2020;16(3):559-564.doi: 10.4103/jcrt.JCRT_702_18
- Takayama K, Nakamura T, Takada A. Treatment results of alternating chemoradiotherapy followed by proton beam therapy boost combined with intra-arterial infusion chemotherapy for stage III-IVB tongue cancer. J Cancer Res Clin Oncol. 2016;142(3):659-67. doi: 10.1007/s00432-015-2069-0
- Engibaryan MA, Gvaramiya AK. An innovative approach to the treatment of locally advanced tongue cancer. Modern problems of science and education. 2021;1. [Енгибарян М.А., Гварамия А.К. Инновационный подход к лечению местнораспространенного рака языка. Современные проблемы науки и образования. 2021;1]. doi: 10.17513/spno.30399
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