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Combination therapy of intra-arterial CBDCA infusion and radiation as the initial treatment for locally advanced oral cancer
P22-7 Diagnosis of neoplasm of chemotherapy, radiation, and operation on cellular immunity. The results of T classification and immunological parameter of single-color analysis showed that the percentage of CD3 + cells decreased significantly with upgrading of T classification. The result of T classification and immunological parameter of two-color analysis showed that the percentage of CD3+HLA-cells and that of CD57-CD16-cells decreased significantly with upgrading of the T classification. The result of N classification and immunological parameter of single-color analysis showed that N K activity increased with upgrading of the N classification. The result of stage classification and immunological parameter of single-color analysis showed that the percentage of CD3+ cells decreased with upgrading of the stage. The result of differentiation and immunological parameter of single-color analysis showed that both the percentage of CD25+ cells decreased but that of CD16+ cells increased with upgrading of the differentiation. These findings suggested that an increase of tumor dimension inhibited T-cell immunity. Furthermore, it was speculated that histological differentiation had some effect on cellular immunity.
8. Clinico-Pathologic Studies on the Significance of Systematic Treatment of Squamous Cell Carcinoma of the Oral Regions
223
9. Combination Therapy of Intra-Arterial CBDCA Infusion and Radiation as the Initial Treatment for Locally Advanced Oral Cancer
Ichihara, H., Okutomi, T., Fujitsuka, H., Wani, T., Yasuda, S., Sakai, T., Tatematsu, N.
Department of OMS, Gifu Univ. School of Medicine, Gifu, Japan Since 1993, we have treated locally invasive oral squamous cell carcinomas (8 cases in the tongue and oral floor, 2 cases in the buccal mucosa, 3 cases in the upper alveolar and gingiva, and 2 cases in the lower alveolar and gingiva) by a combination of radiotherapy and intra-arterial chemotherapy as the initial treatment. The latter was conducted by inserting a catheter from the superficial temporal artery for one-shot CBDCA administration. The dose of CBDCA was decided by the body surface area and creatinine clearance. A total dose of 30 to 50 Gy of external radiation using 60C ~ was given. About two weeks after the initial treatment, a radical surgery of the primary site was performed. A clinical CR was obtained in 1 case, a clinical PR in 12 cases, a clinical MR in 1 case and a clinical NC in 1 case. A case of clinical PR obtained a pathological CR after the radical operation. The most problematic side effects were leukopenia and thrombocytopenia, but the appearance of stomatitis was slight.
Arasaki, A., Sunakawa, 1-1., Hiratuka, H., Kishaba, M., Tsuhako, W., Miyazato, K.
Department of Oral Surgery, School of Medicine, University of the Ryukyus, Okinawa, Japan The purpose of this study was to assess the value of systematic oral cancer treatment based on clinicopathologic malignancy grade in our clinic. Two-hundred and ten patients with oral squamous cell carcinoma were surgically operated on after induction chemotherapy based on both the clinicopathologic malignancy grade and the effects of induction chemotherapy. These cases were clinicopathologically examined to determine the value of systematic oral cancer treatment in our clinic. The subjects were 210 patients that consisted of 160 males and 50 females whose average age was 60.8 years. The clinical findings were that 128 cases were TI or T2, 82 cases were T3 or T4, 97 cases were stage I or stage II, and 113 cases were stage III or stage IV. Histologically, there were 47 cases of well-differentiated type, 139 cases of moderately-differentiated type, and 24 cases of poorly-differentiated type. Regarding the mode of cancer cell invasion, there were 64 cases of type-1 or type-2, 84 cases of type-3, 44 cases of type-4C and 18 cases of type-4D. The clinical effects of induction chemotherapy were marked in 33 cases, moderate in 82 cases, and slight or ineffective in 94 cases. The histological effects of induction chemotherapy were Grade I (Shimosato's classification) in 41 cases, Grade IIA in 46 cases, Grade. IIB in 74 cases, Grade III in 18 cases, and Grade IV in 29 cases. The total five-year cumulative survival rate was 77.0%, which was favorable.
10. The Influence of Antiemetics on the Clinical Response of Neoadjuvant Chemotherapy
Komatsu, H., Shikimori, M., Koyama, T., Yamaguchi, K., Fukuda, H., Hashimoto, K. Department of Oral-and Maxillofacial Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan Introduction In our clinic, neoadjuvant chemotherapy with THP-ADM, CDDP and PEP (TPP therapy) has shown high clinical response on oral squamous cell carcinoma. The possibility that the antiemetics will influence the pharmacokinetics of chemotherapeutic drugs has been recently investigated. In this paper, the influence of antiemetics on the primary effect of TPP therapy on oral carcinoma is discussed clinically. Materials and Methods Of the 96 cases of oral squamous cell carcinoma in which TPP therapy was applied from 1990 to 1996, 84 cases were evaluated with respect to the primary effect of TPP therapy and antiemetics. The antiemetic, granisetron, was used in 58 cases (38 males, 25 females, average age of 61.0 y.o.) (group G), and 26 cases (15 males, 11 females, average age of 59.0 y.o.) (group non-G) were treated with other antiemetics. The clinical response was evaluated within standardized guidelines set by the Japanese Society for Head & Neck Cancer.
8. Clinico-Pathologic Studies on the Significance of Systematic Treatment of Squamous Cell Carcinoma of the Oral Regions
223
9. Combination Therapy of Intra-Arterial CBDCA Infusion and Radiation as the Initial Treatment for Locally Advanced Oral Cancer
Ichihara, H., Okutomi, T., Fujitsuka, H., Wani, T., Yasuda, S., Sakai, T., Tatematsu, N.
Department of OMS, Gifu Univ. School of Medicine, Gifu, Japan Since 1993, we have treated locally invasive oral squamous cell carcinomas (8 cases in the tongue and oral floor, 2 cases in the buccal mucosa, 3 cases in the upper alveolar and gingiva, and 2 cases in the lower alveolar and gingiva) by a combination of radiotherapy and intra-arterial chemotherapy as the initial treatment. The latter was conducted by inserting a catheter from the superficial temporal artery for one-shot CBDCA administration. The dose of CBDCA was decided by the body surface area and creatinine clearance. A total dose of 30 to 50 Gy of external radiation using 60C ~ was given. About two weeks after the initial treatment, a radical surgery of the primary site was performed. A clinical CR was obtained in 1 case, a clinical PR in 12 cases, a clinical MR in 1 case and a clinical NC in 1 case. A case of clinical PR obtained a pathological CR after the radical operation. The most problematic side effects were leukopenia and thrombocytopenia, but the appearance of stomatitis was slight.
Arasaki, A., Sunakawa, 1-1., Hiratuka, H., Kishaba, M., Tsuhako, W., Miyazato, K.
Department of Oral Surgery, School of Medicine, University of the Ryukyus, Okinawa, Japan The purpose of this study was to assess the value of systematic oral cancer treatment based on clinicopathologic malignancy grade in our clinic. Two-hundred and ten patients with oral squamous cell carcinoma were surgically operated on after induction chemotherapy based on both the clinicopathologic malignancy grade and the effects of induction chemotherapy. These cases were clinicopathologically examined to determine the value of systematic oral cancer treatment in our clinic. The subjects were 210 patients that consisted of 160 males and 50 females whose average age was 60.8 years. The clinical findings were that 128 cases were TI or T2, 82 cases were T3 or T4, 97 cases were stage I or stage II, and 113 cases were stage III or stage IV. Histologically, there were 47 cases of well-differentiated type, 139 cases of moderately-differentiated type, and 24 cases of poorly-differentiated type. Regarding the mode of cancer cell invasion, there were 64 cases of type-1 or type-2, 84 cases of type-3, 44 cases of type-4C and 18 cases of type-4D. The clinical effects of induction chemotherapy were marked in 33 cases, moderate in 82 cases, and slight or ineffective in 94 cases. The histological effects of induction chemotherapy were Grade I (Shimosato's classification) in 41 cases, Grade IIA in 46 cases, Grade. IIB in 74 cases, Grade III in 18 cases, and Grade IV in 29 cases. The total five-year cumulative survival rate was 77.0%, which was favorable.
10. The Influence of Antiemetics on the Clinical Response of Neoadjuvant Chemotherapy
Komatsu, H., Shikimori, M., Koyama, T., Yamaguchi, K., Fukuda, H., Hashimoto, K. Department of Oral-and Maxillofacial Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan Introduction In our clinic, neoadjuvant chemotherapy with THP-ADM, CDDP and PEP (TPP therapy) has shown high clinical response on oral squamous cell carcinoma. The possibility that the antiemetics will influence the pharmacokinetics of chemotherapeutic drugs has been recently investigated. In this paper, the influence of antiemetics on the primary effect of TPP therapy on oral carcinoma is discussed clinically. Materials and Methods Of the 96 cases of oral squamous cell carcinoma in which TPP therapy was applied from 1990 to 1996, 84 cases were evaluated with respect to the primary effect of TPP therapy and antiemetics. The antiemetic, granisetron, was used in 58 cases (38 males, 25 females, average age of 61.0 y.o.) (group G), and 26 cases (15 males, 11 females, average age of 59.0 y.o.) (group non-G) were treated with other antiemetics. The clinical response was evaluated within standardized guidelines set by the Japanese Society for Head & Neck Cancer.