Superselective intra-arterial chemotherapy combined with radiotherapy for the skull base neoplasm

Superselective intra-arterial chemotherapy combined with radiotherapy was performed for advanced nasal cavity and paranasal sinus cancers that were considered to involve the base of the skull or have some bone involvement to evaluate the efficacy of first line therapy and adverse events (AEs). Assessment of the efficacy of first line therapy, which took into consideration the postoperative pathological findings, demonstrated complete and objective response rates of 65% and 92.5%, respectively. Only one grade 4 AE occurred. The other AEs were all reversible and no serious AEs were observed. As our future therapeutic strategy, we have changed our practice and are investigating the possibility of superselective intra-arterial chemotherapy concurrent with 60 Gy radiotherapy regardless of the T classification followed by a salvage operation at the time of confirmation of residual or recurrent carcinoma while adopting a wait-and-see approach. (author)