Intra-Arterial Chemotherapy for Locally Advanced Oral Cavity Cancer

Introduction : The standard treatment for locally advanced oral cavity cancer is surgery with followed by chemoradiotherapy Surgical treatment carries serious external and aesthetic risks and a long period of rehabilitation. On the other hand, standard chemoradiation treatment does not achieve adequate results. Intra-arterial chemotherapy is a promising treatment option. This method allows targeting the tumor to be while minimizing systemic factors and organ preservation, and the quality of life of the patients. Purpose : To compare the results of treatment of patients with locally advanced oral cancer using induction intra-arterial chemotherapy and surgical treatment at the first step. Material and methods : 62 patients were treated from 2017 to 2023 with locally advanced oral cancer. 23 patients underwent induction chemotherapy according to the DCF regimen with intra-arterial administration of cisplatin and docetaxel. In the second group, 39 patients underwent combined treatment with surgical treatment at the first step. The primary endpoint of the study was overall and disease-free survival. Secondary — objective response, treatment toxicity and the occurrence of prognostic factors in the intra-arterial chemotherapy group. Results : The duration of follow-up of patients in the intra-arterial group was 20.37 (CI 13.23–25.87) and in the surgery group 32.6 (CI 17.1–43.6) months. 1-year overall survival (OS) in the intra-arterial group and in the surgical group was 84.1 % and 69.2 % ( p = 0.582), relapse-free survival (RFS) — 77.9 % and 62.5 % ( p = 0.944). A subgroup analysis revealed an improvement in OS in patients treated with one arterial basin ( p = 0.005). 1-year OS aſter induction chemotherapy for complete response, partial response, and stabilization were 90.9, 67.5, and 0 % ( p < 0.001), respectively. 1-year RFS for complete response, partial response, and stabilization were 80, 76.2, and 0 % ( p < 0.000), respectively. Conclusions : Intra-arterial chemotherapy has equivalent efficacy in terms of survival in patients with locally advanced tumors, oral cavity conclusion is indicated.