A Novel Intraarterial Chemotherapy Using Paclitaxel in Albumin Nanoparticles to Treat Advanced Squamous Cell Carcinoma of the Tongue: Preliminary Findings
Bruno Damascelli1,
Gian Luigi Patelli1,
Rodolfo Lanocita1,
Giuseppe Di Tolla1,
Laura Francesca Frigerio1,
Alfonso Marchianò1,
Francesco Garbagnati1,
Carlo Spreafico1,
Vladimira Tichà1,
Caroline Regna Gladin1,
Mauro Palazzi2,
Flavio Crippa3,
Cesare Oldini4,
Stefano Calò4,
Alberto Bonaccorsi4,
Franco Mattavelli5,
Luigi Costa5,
Luigi Mariani6 and
Giulio Cantù5
1 Department of Radiology, Istituto Nazionale Tumori, Via Venezian, 1, Milano
20133, Italy.
2 Department of Radiotherapy, Istituto Nazionale Tumori, Milano 20133,
Italy.
3 Department of Nuclear Medicine, Istituto Nazionale Tumori, Milano 20133,
Italy.
4 Department of Head and Neck Surgery, Ospedale di Lodi, Lodi 26900, Italy
5 Department of Head and Neck Surgery, Istituto Nazionale Tumori, Milano 20133,
Italy.
6 Department of Statistics and Biometry, Istituto Nazionale Tumori, Milano
20133, Italy.
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Fig. 1. —Photomicrograph shows paclitaxel in albumin nanoparticles
seen under electron microscope at x39.000 magnification. Round albumin
nanoparticles are arranged on formvar carbon—coated grid of electron
microscope. Arrows indicate nanoparticles.
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Fig. 2. —Artist's rendering of selective intraarterial chemotherapy
technique for tumors of tongue using paclitaxel-charged human albumin
nanoparticles. 1 = guide catheter, 2 = heparinized saline for catheter
flushing, 3 = infusion catheter, 4 = albumin nanoparticles.
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Fig. 3A. —70-year-old woman with squamous cell carcinoma of tongue. In
photograph acquired at presentation, tumor is seen at right lateral margin of
tongue.
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Fig. 3B. —70-year-old woman with squamous cell carcinoma of tongue. FDG
positron emission tomographic (PET) scan reveals intense FDG uptake at tumor
site.
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Fig. 3C. —70-year-old woman with squamous cell carcinoma of tongue. FDG
PET scan obtained in section caudad to that of B depicts FDG uptake in
upper right laterocervical lymph node.
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Fig. 3D. —70-year-old woman with squamous cell carcinoma of tongue.
Lateral angiogram of right common carotid artery shows lingual artery.
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Fig. 3E. —70-year-old woman with squamous cell carcinoma of tongue.
Lateral angiogram shows superselective catheterization of right lingual artery
before infusion of paclitaxel in albumin nanoparticles.
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Fig. 3F. —70-year-old woman with squamous cell carcinoma of tongue. FDG
PET scan obtained 12 weeks later than B after patient had received four
infusions of paclitaxel-charged human albumin nanoparticles shows lack of FDG
uptake at primary tumor site.
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Fig. 3G. —70-year-old woman with squamous cell carcinoma of tongue. FDG
PET scan obtained 9 weeks later than C (i.e., after three infusions of
paclitaxel-charged human albumin nanoparticles) shows lack of FDG uptake at
site of lymph node metastasis.
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Fig. 3H. —70-year-old woman with squamous cell carcinoma of tongue.
Photograph depicts complete clinical response, with absence of mucositis and
replacement of tumor with whitish scar.
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Fig. 3I. —70-year-old woman with squamous cell carcinoma of tongue.
Photograph shows surgical resection obtained with wide margin around scar.
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Fig. 3J. —70-year-old woman with squamous cell carcinoma of tongue.
Photomicrograph of histopathologic specimen shows single area of tumor residue
(arrows) measuring less than 1 mm. (H and E, x400)
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Fig. 4A. —69-year-old-man with squamous cell carcinoma of base of
tongue Enhanced axial multidetector CT (MDCT) scan of neck shows carcinoma
(arrows) of base of tongue.
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Fig. 4B. —69-year-old-man with squamous cell carcinoma of base of
tongue Enhanced axial MDCT scan of neck shows complete response after three
intraarterial infusions of paclitaxel-charged human albumin nanoparticles.
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Fig. 4C. —69-year-old-man with squamous cell carcinoma of base of
tongue FDG positron emission tomographic (PET) scan obtained at presentation
shows intense FDG uptake.
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Fig. 4D. —69-year-old-man with squamous cell carcinoma of base of
tongue FDG PET scan obtained 9 weeks later than C (after three
infusions) shows absence of FDG uptake. At physical examination, superficial
nodule measuring less than 1 cm was detected and biopsied.
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Copyright © 2003 by the American Roentgen Ray Society.
