title: A novel intraarterial chemotherapy using paclitaxel in albumin nanoparticles to treat advanced squamous cell carcinoma of the tongue: preliminary findings.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the effectiveness of intraarterial infusion of paclitaxel incorporated into human albumin nanoparticles for use as induction chemotherapy before definitive treatment of advanced squamous cell carcinoma of the tongue.
  
  
  METHODS
  Twenty-three previously untreated patients (age range, 27-75 years) who had carcinoma of the tongue (stage T3-T4, any N) received intraarterial therapy with paclitaxel incorporated into albumin nanoparticles delivered by transfemoral catheterization into the external carotid artery (10 patients), selectively into the lingual artery (12 patients), or into a faciolingual trunk (1 patient). Each patient received two to four infusions, with a 3-week interval between infusions. The dose administered was 230 mg/m(2) in eight patients, 180 mg/m(2) in six patients, and 150 mg/m(2) in nine patients. Sixteen patients underwent surgery. Of these 16 patients, eight subsequently received radiotherapy, and three received a combination of chemotherapy and radiotherapy. Of the remaining seven patients, one received chemotherapy alone, four received radiotherapy alone, one received chemotherapy plus radiotherapy, and one refused any further treatment.
  
  
  RESULTS
  Sixty-seven infusions were performed successfully. Eighteen patients (78%) had a clinical and radiologic objective response (complete, 26%; partial, 52%). Three patients (13%) showed stable disease, and two (9%) showed disease progression. The four patients with complete clinical response who underwent surgery showed microscopic residual carcinoma measuring less than 1 mm in two patients, less than 5 mm in one patient, and less than 1 cm in one patient. The toxicities encountered were hematologic (grade 3) in two patients (8.6%) and neurologic (grade 4) in two patients (reversible paralysis of the facial nerve, 8.6%). Two catheter-related complications occurred: one reversible brachiofacial paralysis and one asymptomatic occlusion of the external carotid artery.
  
  
  CONCLUSIONS
  Intraarterial infusion of paclitaxel in albumin nanoparticles proved reproducible and effective and deserves further investigation as induction chemotherapy before definitive treatment of advanced tumors of the tongue, with a view to organ preservation.
authors.affiliation: Department of Radiology, Istituto Nazionale Tumori, Via Venezian, 1, Milano 20133, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Damascelli
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Patelli
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Lanocita
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Di Tolla
authors.forename: Laura Francesca
authors.initials: LF
authors.lastname: Frigerio
authors.forename: Alfonso
authors.initials: A
authors.lastname: Marchianò
authors.forename: Francesco
authors.initials: F
authors.lastname: Garbagnati
authors.forename: Carlo
authors.initials: C
authors.lastname: Spreafico
authors.forename: Vladimira
authors.initials: V
authors.lastname: Tichà
authors.forename: Caroline Regna
authors.initials: CR
authors.lastname: Gladin
authors.forename: Mauro
authors.initials: M
authors.lastname: Palazzi
authors.forename: Flavio
authors.initials: F
authors.lastname: Crippa
authors.forename: Cesare
authors.initials: C
authors.lastname: Oldini
authors.forename: Stefano
authors.initials: S
authors.lastname: Calò
authors.forename: Alberto
authors.initials: A
authors.lastname: Bonaccorsi
authors.forename: Franco
authors.initials: F
authors.lastname: Mattavelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Costa
authors.forename: Luigi
authors.initials: L
authors.lastname: Mariani
authors.forename: Giulio
authors.initials: G
authors.lastname: Cantù
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage* / Q000627:therapeutic use; D010316:Particle Size; D012709:Serum Albumin / Q000008:administration & dosage; D014062:Tongue Neoplasms / Q000188:drug therapy*
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D012709:Serum Albumin; D017239:Paclitaxel