Proton beam therapy combined with retrograde intra‑arterial infusion chemotherapy for an extremely rapid growing recurrent ameloblastic carcinoma: A case report

Takayama,Kanako; Nakamura,Tatsuya; Takada,Akinori; Kato,Takahiro; Sakuma,Hideo; Mitsudo,Kenji; Fuwa,Nobukazu; Murakami,Masao

doi:10.3892/mco.2020.2104

Proton beam therapy combined with retrograde intra‑arterial infusion chemotherapy for an extremely rapid growing recurrent ameloblastic carcinoma: A case report

Authors:
- Kanako Takayama
- Tatsuya Nakamura
- Akinori Takada
- Takahiro Kato
- Hideo Sakuma
- Kenji Mitsudo
- Nobukazu Fuwa
- Masao Murakami
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Affiliations: Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Fukushima 963‑8052, Japan, Department of Radiology, Mie University Hospital, Tsu, Mie 514‑8507, Japan, Department of Pathology, Southern Tohoku General Hospital, Koriyama, Fukushima 963‑8563, Japan, Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236‑0004, Japan, Department of Radiation Oncology, Ise Red Cross Hospital, Ise, Mie 516‑0008, Japan
Published online on: July 30, 2020 https://doi.org/10.3892/mco.2020.2104
Article Number: 34
Copyright: © Takayama et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Ameloblastic carcinoma (AC) is a very rare malignant odontogenic tumor. Although surgical resection is generally performed, treatment approaches have not been established for recurrent cases. Chemotherapy and radiotherapy are positioned as adjunctive therapies, and few studies investigated definitive non‑operative therapy. We present the case of a 71‑year‑old male with recurrent secondary‑type AC arising from the right maxilla, who was treated with proton beam therapy (PBT; 71.4 Gy relative biological effectiveness in 32 fractions) combined with continuous intra‑arterial infusion of cisplatin (40 mg/m²) and docetaxel (8 mg/m²). The patient experienced acute grade 3 mucositis, dermatitis and neutropenia, which were resolved within 3 months of treatment. Late adverse events were grade 1 skin atrophy, and grade 2 right optic nerve disorder and retinopathy. After ~8 years of treatment, the patient died from another cause but did not experience any relapse or metastasis during the follow‑up period of 94 months. To the best of our knowledge, this is the first report of recurrent AC treated with PBT and intra‑arterial infusion chemotherapy without any severe late adverse events. This combination therapy approach may be considered as an effective therapeutic option for inoperable AC.

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