Efficacy and Safety of Intro-Arterial Chemotherapy Combined with Radiotherapy on Head and Neck Cancer: A Systematic Review and Meta-Analysis

Abstract

Objectives: Intro-arterial chemotherapy combined with radiotherapy (IACRT) for the treatment of head and neck cancer (HNC) underwent a revival in recent years. Although many clinical trials have reported favorable outcomes, the effect of IACRT for HNC is still controversial. Therefore, this study was designed to evaluate the efficacy and safety of IACRT for HNC. Methods: The relevant articles published before August 2019 were searched from PubMed, Embase, Cochrane Library, Web of Science and PMC databases. Data were extracted and the combined complete response (CR), overall survival (OS) and toxicity incidence with 95% credible interval (CI) were examined from eligible studies. Results: Thirty-four studies comprising 1890 patients were included. IACRT achieved high CR (0.81, 95% CI: 0.76-0.86, P < 0.001), 3-year OS (0.75, 95% CI: 0.68-0.82, P < 0.001) and 5-year OS (0.68, 95% CI: 0.61-0.75, P < 0.001). The 3-year OS rate of stage III cancer (0.75, 95% CI: 0.53-0.97, P< 0.001) was higher than stage IV (0.52, 95% CI: 0.37-0.66, P = 0.025). Meanwhile, the 5-year OS of T3 cancer (0.87, 95% CI: 0.73-1.01, P = 0.028) was higher than T4 (0.53, 95% CI: 0.42-0.63, P = 0.286). Additionally, oral diseases, mucositis, leukopenia and dermatitis were the major toxicities of IACRT, which were all reversible. Conclusion: IACRT is an efficient and safe modality for HNC, which could achieve favorable cancer response and higher survival rate with acceptable toxicities, even for advanced HNC.

Shuterin Enhances the Cytotoxicity of the Natural Killer Leukemia Cell Line KHYG-1 by Increasing the Expression Levels of Granzyme B and IFN-γ through the MAPK and Ras/Raf Signaling Pathways

“…Owing to advancements in treatment modalities, the survival rate of patients with HNSCC increased from 55 to 66% between 1996 and 2006. The poor survival rate associated with HNSCC can be attributed to laryngeal cancer and old age [ 54 , 55 , 56 ]. In the present study, shuterin markedly improved the cytotoxicity of KHYG-1 cells.…”

7-Epitaxol Induces Apoptosis and Autophagy in Head and Neck Squamous Cell Carcinoma through Inhibition of the ERK Pathway

“…In patients with non-metastatic small primary tumors, a cure rate of more than 80% can be achieved by resection or radiation. Similarly, in high-risk patients with recurrent or metastatic cancer, postoperative concurrent application of radiotherapy and chemotherapy has been shown to increase disease-free survival [9]. With the advancement in treatment strategies, the survival rate of HNSCC has increased from 55% in 1996 to 66% in 2006.…”

Ligation of the ethmoid arteries in superselective intra‐arterial infusion of cisplatin for advanced maxillary sinus cancer fed by the ophthalmic artery

“…To take advantage of this unique vascular distribution, RADPLAT for maxillary sinus cancer is designed to superselectively administer high-dose CDDP via the branches of the ECA using small catheters during irradiation. 10 In a retrospective observational study of patients with T4 squamous cell carcinoma of the maxillary sinus in Japan, similar oncological outcomes were obtained compared with total maxillectomy with or without orbital exenteration, with significantly better cosmetic and functional outcomes. 11 Administration of CDDP from the main trunk of the ICA or ophthalmic artery to the maxillary sinus, which is partly fed by the ophthalmic artery, has been reported by several authors with favorable oncological results.…”

“…The blood supply to locally advanced primary squamous cell carcinoma of the maxillary sinus is mostly delivered from the branches of the ECA. To take advantage of this unique vascular distribution, RADPLAT for maxillary sinus cancer is designed to superselectively administer high‐dose CDDP via the branches of the ECA using small catheters during irradiation 10 . In a retrospective observational study of patients with T4 squamous cell carcinoma of the maxillary sinus in Japan, similar oncological outcomes were obtained compared with total maxillectomy with or without orbital exenteration, with significantly better cosmetic and functional outcomes 11 …”