Initial experience of proton therapy combined with selective intra-arterial infusion chemotherapy for locally advanced tongue cancer

Between February 2009 and January 2010, 13 patients with locally advanced squamous cell carcinoma of the tongue underwent proton beam therapy combined with intra-arterial infusion chemotherapy via a superficial temporal artery. Their characteristics were as follows: median age 64 years old, 4 females and 9 males. Two patients were clinical stage III and 11 patients were clinical stage IVA. Though the follow-up period was short, the initial results of this therapy were 12 complete response (CR) and 1 partial response (PR). Later, local recurrence was detected in 4 patients and neck recurrence was detected in 2 patients. The local control rate for the primary site and the neck were 69.2% (9/13) and 80.0% (2/10), respectively. In cases of local recurrence, most of them occurred from non-perfusion areas; there was no case with distant metastasis and osteoradiation necrosis of the mandibular bone and tooth during the follow-up period. These results confirm the importance of examining the perfusion area. Though the period of observation was short, proton beam therapy combined with intra-arterial infusion chemotherapy is thought to be an effective treatment for locally advanced tongue cancer, and proton therapy may also be effective for cervical lymph node metastases. (author)