title: Impact of intra-arterial chemotherapy including internal carotid artery for advanced paranasal sinus cancers involving the skull base.
abstract: BACKGROUND
  The most significant problem of intra-arterial chemotherapy for advanced paranasal sinus carcinomas and residual cancers supplied by internal carotid artery (ICA) and involving the skull base is the lack of salvage therapies.
  
  
  OBJECTIVE
  The objective of the study was to evaluate the usefulness of intra-arterial chemotherapy including ICA infusion for treating advanced paranasal sinus carcinomas, which have invaded the skull base.
  
  
  METHODS
  Forty-six patients with advanced paranasal sinus carcinomas supplied by ICA were treated by intra-arterial chemotherapy using CDDP and sodium thiosulphate (STS) as a neutraliser of CDDP toxicity. After evaluating CT angiography, 150 mg m(-2) of CDDP was superselectively administered weekly to each feeding artery including ICA four times.
  
  
  RESULTS
  The 10-year overall survival rate and progression-free survival rate were 70.7 and 60.2%, respectively. Compared with control group without infusing ICA, recurrences at anterior skullbase or anterior ethomoid sinus were significantly diminished. Of 32 patients in which the orbital apex had been invaded, 29 patients were treated with successful preservation of orbital contents. The CT angiography could efficiently determine all feeding arteries supplying the cancers. Consequently, chemotherapy could be administered on schedule, and side effects were minimal and acceptable.
  
  
  CONCLUSIONS
  This new method has promising applications in the treatment of advanced paranasal sinus carcinomas involving the skull base.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Yokoyama
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ohba
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fujimaki
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Anzai
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kojima
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ikeda
authors.affiliation: Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Second Department of Oral Maxillofacial Surgery, Osaka Dental University, Osaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yoshimoto
authors.affiliation: Department of radiology, Tochigi Cancer Center, Utsunomiya, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Inoue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002343:Carotid Artery, Internal; D002945:Cisplatin / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin