���行声門癌 (t3, 4) 症例に対する超選択的動注療法による喉頭温存療法の検討

Patients with advanced glottic squamous cell cancers (T3, 4) have poor outcomes, losing important functions such as speech despite combined surgery and radiotherapy. The 5-year laryngeal preservation rate by conventional radiotherapy has been reported to be about 23%. Thirty patients with advanced glottic laryngeal cancers were treated by superselective intra-arterial chemotherapy using CDDP and so-dium thiosulfate (STS) from 1997 to 2005. Once a week, 100mg/m2 of CDDP was administered superselectively at 5 mg/min through each feeding artery of the tumor. During the infusion of CDDP, STS at a dose of two hundred fold of the CDDP was injected through a catheter placed in the subclavian vein. The 5-year laryngeal preservation rate was 81% with good functional preservation of larynx. Though we preserve all larynxes, three total laryngectomies had to be performed due to severe dysfunction. It was suspected that dysfunction in these three cases could have been induced by the administration of too high a dose of CDDP. With superselective intra-arterial chemotherapy, we have proposed a new method for determining the dose of CDDP to be administered by measuring tumor volume rather than surface area. We were able to suppress mucositis of normal tissue and local recurrence using CT-angiography.