Skip to main content
SpringerLink
Log in

Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

We sought to evaluate the efficacy and feasibility of superselective intra-arterial infusion of high-dose cisplatin with concomitant radiotherapy (hereafter RADPLAT) for head and neck squamous cell cancer (hereafter HNSCC) patients with retropharyngeal lymph node (hereafter RPLN) metastasis. A retrospective case series review was conducted at University medical center in Japan. Ten HNSCC patients with RPLN metastasis treated by RADPLAT were analyzed. The ascending pharyngeal artery was targeted for the treatment of RPLN metastasis in 9 patients. The median total dose of cisplatin was 26.6 mg/m2 (mean 31.5 mg/m2, range 11.7–87.9 mg/m2). In the remaining patient, the RPLN was supplied by the ascending palatine artery. As grade 3 and 4 adverse effects, leukopenia was observed in three, mucositis in four and nausea in one patient. No neurological complications were observed in any patients. Metastatic RPLNs were evaluated as a complete response in all patients. There was no recurrence of RPLN metastasis in any patients. Four patients remain alive without any evidence of disease and six patients died of disease. The 5-year overall survival rate was 50 %. We have shown that superselective intra-arterial cisplatin infusion for RPLNs was a feasible and effective approach for HNSCC patients with RPLN metastasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. McLaughlin MP, Mendenhall WM, Mancuso AA et al (1995) Retropharyngeal adenopathy as a predictor of outcome in squamous cell carcinoma of the head and neck. Head Neck 17:190–198

    Article  CAS  PubMed  Google Scholar 

  2. Ogino A, Tsukuda M, Inoue T et al (2007) Prognostic value of retropharyngeal node involvement in CT-based lymph node-positive pharyngeal cancer following radiotherapy. Anticancer Res 27:1663–1668

    PubMed  Google Scholar 

  3. Coskun HH, Ferlito A, Medina JE et al (2011) Retropharyngeal lymph node metastases in head and neck malignancies. Head Neck 33:1520–1529

    Article  PubMed  Google Scholar 

  4. Robbins KT, Storniolo AM, Kerber C et al (1992) Rapid superselective high-dose cisplatin infusion for advanced head and neck malignancies. Head Neck 14:364–371

    Article  CAS  PubMed  Google Scholar 

  5. Robbins KT, Fontanesi J, Wong FS et al (1996) A novel organ preservation protocol for advanced carcinoma of the larynx and pharynx. Arch Otolaryngol Head Neck Surg 122:853–857

    Article  CAS  PubMed  Google Scholar 

  6. Homma A, Furuta Y, Suzuki F et al (2005) Rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for advanced head and neck cancer. Head Neck 27:65–71

    Article  PubMed  Google Scholar 

  7. Ballantyne AJ (1964) Significance of retropharyngeal nodes in cancer of the head and neck. Am J Surg 108:500–504

    Article  CAS  PubMed  Google Scholar 

  8. Mancuso AA, Harnsberger HR, Muraki AS, Stevens MH (1983) Computed tomography of cervical and retropharyngeal lymph nodes: normal anatomy, variants of normal, and applications in staging head and neck cancer. Part I: normal anatomy. Radiology 148:709–714

    Article  CAS  PubMed  Google Scholar 

  9. Tseng JR, Ho TY, Lin CY et al (2013) Clinical outcomes of patients with oral cavity squamous cell carcinoma and retropharyngeal lymph node metastasis identified by FDG PET/CT. PLoS ONE 8:e79766

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Chung EJ, Oh JI, Choi KY et al (2011) Pattern of cervical lymph node metastasis in tonsil cancer: predictive factor analysis of contralateral and retropharyngeal lymph node metastasis. Oral Oncol 47:758–762

    Article  PubMed  Google Scholar 

  11. Hasegawa Y, Matsuura H (1994) Retropharyngeal node dissection in cancer of the oropharynx and hypopharynx. Head Neck 16:173–180

    Article  CAS  PubMed  Google Scholar 

  12. Rouvie`re H (1938) Lymphatic system of the head and neck. In: Tobias MJ (ed) Anatomy of the human lymphatic system. Edwards Brothers, Ann Arbor, pp 5–28

    Google Scholar 

  13. Pfreundner L, Pahnke J, Willner J (2000) Systematics in lymphatic tumor spread of carcinomas of the upper aerodigestive tract: a clinical study based on embryologic data. Eur Arch Otorhinolaryngol 257:561–569

    Article  CAS  PubMed  Google Scholar 

  14. Ferlito A, Shaha AR, Rinaldo A (2002) Retropharyngeal lymph node metastasis from cancer of the head and neck. Otolaryngol 122:556–560

    Article  Google Scholar 

  15. Amatsu M, Mohri M, Kinish M (2001) Significance of retropharyngeal node dissection at radical surgery for carcinoma of the hypopharynx and cervical esophagus. Laryngoscope 111:1099–1103

    Article  CAS  PubMed  Google Scholar 

  16. Chung EJ, Kim GW, Cho BK et al (2015) Retropharyngeal lymph node metastasis in 54 patients with oropharyngeal squamous cell carcinoma who underwent surgery-based treatment. Ann Surg Oncol 22:3049–3054

    Article  PubMed  Google Scholar 

  17. Robbins KT, Kumar P, Wong FS et al (2000) Targeted chemoradiation for advanced head and neck cancer: analysis of 213 patients. Head Neck 22:687–693

    Article  CAS  PubMed  Google Scholar 

  18. Nomura K, Takahara M, Katayama A et al (2013) Intra-arterial cisplatin with concomitant radiation for advanced hypopharyngeal cancer. Laryngoscope 123(4):916–922

    Article  CAS  PubMed  Google Scholar 

  19. Rasch CR, Hauptmann M, Schornagel J et al (2010) Intra-arterial versus intravenous chemoradiation for advanced head and neck cancer: results of a randomized phase 3 trial. Cancer 116(9):2159–2165

    CAS  PubMed  Google Scholar 

  20. Heukelom J, Lopez-Yurda M, Balm AJ et al (2015) Late follow-up of the randomized radiation and concomitant high-dose intra-arterial or intravenous cisplatin (RADPLAT) trial for advanced head and neck cancer. Head Neck. doi:10.1002/hed.24023

    PubMed  Google Scholar 

  21. Cavalcanti DD, Reis CV, Hanel R et al (2009) The ascending pharyngeal artery and its relevance for neurosurgical and endovascular procedures. Neurosurgery 65(6 Suppl):114–120

    PubMed  Google Scholar 

  22. Geibprasert S, Pongpech S, Armstrong D, Krings T (2009) Dangerous extracranial-intracranial anastomoses and supply to the cranial nerves: vessels the neurointerventionalist needs to know. AJNR Am J Neuroradiol 30(8):1459–1468

    Article  CAS  PubMed  Google Scholar 

  23. Kamiyama R, Saikawa M, Kishimoto S (2009) Significance of retropharyngeal lymph node dissection in hypopharyngeal cancer. Jpn J Clin Oncol 39(10):632–637

    Article  PubMed  Google Scholar 

  24. Ma J, Liu Y, Huang XL et al (2012) Induction chemotherapy decreases the rate of distant metastasis in patients with head and neck squamous cell carcinoma but does not improve survival or locoregional control: a meta-analysis. Oral Oncol 48(11):1076–1084

    Article  CAS  PubMed  Google Scholar 

  25. Ma J, Liu Y, Yang X, et al (2013) Induction chemotherapy in patients with resectable head and neck squamous cell carcinoma: a meta-analysis. World J Surg Oncol. (in press)

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan

    Takayoshi Suzuki, Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi & Satoshi Fukuda

  2. Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda & Hiroki Shirato

  3. Department of Otolaryngology, Hokkaido Medical Center, Sapporo, Japan

    Fumiyuki Suzuki

Authors
  1. Takayoshi Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomohiro Sakashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akihiro Homma
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiromitsu Hatakeyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Satoshi Kano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takatsugu Mizumachi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Daisuke Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Noriyuki Fujima
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Rikiya Onimaru
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kazuhiko Tsuchiya
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Koichi Yasuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Hiroki Shirato
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Fumiyuki Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Satoshi Fukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akihiro Homma.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Suzuki, T., Sakashita, T., Homma, A. et al. Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis. Eur Arch Otorhinolaryngol 273, 3331–3336 (2016). https://doi.org/10.1007/s00405-016-3933-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-016-3933-5

Keywords

Search

Navigation