Professional oral health care reduces oral mucositis pain in patients treated by superselective intra-arterial chemotherapy concurrent with radiotherapy for oral cancer.

PURPOSE: Oral mucositis (OM) is a painful complication of radiation therapy (RT) for head and neck cancer. OM can compromise nutrition, require opioid analgesics and hospitalization for pain control, and lead to interruption of treatment. Severe oral mucositis appears inevitable in superselective intra-arterial chemotherapy concurrent with radiotherapy (SSIACRT), requiring management of OM for the patient. The objective of this study was to assess the utility of professional oral health care (POHC) for the management of OM in patients undergoing SSIACRT. METHODS: Thirty-three patients were enrolled in this study. The first 17 patients underwent SSIACRT before we created an oral management team, and thus did not receive POHC. The remaining 16 patients received POHC. Fever duration, duration of oral feeding difficulty, opioid usage, duration of opioid administration, duration of hospitalization, and number of hospital days from the end of irradiation to discharge were compared between these two groups. RESULTS: Median total dose of morphine during SSIACRT, median number of hospital days from end of irradiation to discharge, and duration of hospitalization all differed significantly between groups (P < 0.05). Duration of opioid administration, fever duration, and duration of oral feeding difficulty did not differ significantly between groups. CONCLUSIONS: These findings indicate that POHC may reduce opioid use and shorten the hospital stay. Such results might be obtained through infection control by POHC. This report appears to be the first study to evaluate the efficiency of POHC in SSIACRT for oral cancer from the perspective of mucositis pain and opioid use.

Comparison of osteoradionecrosis of the jaw after superselective intra-arterial chemoradiotherapy versus conventional concurrent chemoradiotherapy of oral cancer.

PURPOSE: The purpose of the present study was to compare the incidence of osteoradionecrosis between superselective intra-arterial chemoradiotherapy and intravenous chemoradiotherapy and to verify the risk factors for osteoradionecrosis. MATERIALS AND METHODS: Of the 79 patients with oral cancer, 40 were treated with intra-venous chemoradiotherapy and 39 were treated with superselective intra-arterial chemoradiotherapy. The incidence of, and risk factors for, osteoradionecrosis were evaluated using statistical analysis. RESULTS: Of the 79 patients, 4 (10%) of 40 in the intravenous chemoradiotherapy and 7 (17.9%) of 39 in the superselective intra-arterial chemoradiotherapy group developed osteoradionecrosis of the jaw. No significant difference was found between the 2 groups. Although the chemoradiotherapy methods, anatomic tumor location, smoking behavior, alcohol consumption, condition of teeth, teeth extraction before radiation, and progression of dental caries were considered predisposing factors for the occurrence of osteoradionecrosis, only progressive dental caries resulted in a significant difference for osteoradionecrosis. CONCLUSIONS: The present study is the first report comparing the incidence of osteoradionecrosis between superselective intra-arterial chemoradiotherapy and intravenous chemoradiotherapy. The administration methods of anticancer drugs were not related to the incidence of osteoradionecrosis in our study. From our study, dental caries is the most important risk factor for osteoradionecrosis; therefore, a radiation caries prevention program is crucial to control osteoradionecrosis.

Cognitive function and number of teeth in a community-dwelling population in Japan.

BACKGROUND: It has been reported that oral health is poor in elderly populations and is associated with poor cognition and dementia. The objective of this study was to examine the association between tooth loss and cognitive function in a community-dwelling population in Japan. METHODS: We examined the association between tooth loss and cognitive function in 462 Japanese community-dwelling individuals. The Mini-Mental State Examination (MMSE) was employed to measure global cognitive status. A multiple logistic regression analysis, with both crude and adjusted conditions for confounding factors, was used to assess the relationship between poor cognition and the number of remaining teeth. RESULTS: The overall prevalence of poor cognition (MMSE ≤ 23) in this study population was 5.6%. Subjects with poor cognition were significantly older, less educated, scored lower in intellectual activity, and had fewer remaining teeth than those with normal cognition. According to the multiple logistic regression analysis, a lower number of teeth (0-10) was found to be a significant independent risk factor (OR = 20.21, 95% confidence interval = 2.20 to 185.47) of cognitive impairment. CONCLUSIONS: This cross-sectional study on a Japanese community-dwelling population revealed relationships between tooth loss and cognitive function. However, the interpretation of our results was hampered by a lack of data, including socioeconomic status and longitudinal observations. Future research exploring tooth loss and cognitive function is warranted.

Characterization of synergistic induction of CX3CL1/fractalkine by TNF-alpha and IFN-gamma in vascular endothelial cells: an essential role for TNF-alpha in post-transcriptional regulation of CX3CL1.

CX3CL1/fractalkine, a chemokine specific to monocytes and NK cells, is induced synergistically by TNF-alpha and IFN-gamma in vascular endothelial cells. However, the mechanism for this synergism remains unclear. This study explored the hypothesis that the CX3CL1 expression is regulated at a posttranscriptional level, which may responsible for the synergism between TNF-alpha and IFN-gamma. Brief exposure of HUVECs to TNF-alpha led to a robust increase in IFN-gamma-induced CX3CL1 production. We found that TNF-alpha stabilized CX3CL1 mRNA in HUVECs stimulated with IFN-gamma. Cloning of 3' untranslated region (UTR) of CX3CL1 mRNA revealed the presence of a single copy of nonametric AU-rich element in its 3'UTR, and a luciferase reporter assay showed that a single AU-rich element is a crucial cis-element in the posttranscriptional regulation of CX3CL1. TNF-alpha treatment resulted in the phosphorylation of p38 MAPK and its downstream target, MAPK-activated protein kinase-2, but IFN-gamma did not affect the levels of MAPK and MAPK-activated protein kinase-2 phosphorylation induced by TNF-alpha. Treatment of the cells with an inhibitor of p38 MAPK accelerated the decay of CX3CL1 mRNA induced by TNF-alpha or the combination of TNF-alpha and IFN-gamma. Immunoprecipitation assay revealed that mRNA stabilizer HuR directly binds to 3'UTR of CX3CL1 mRNA. CX3CL1 expression is under control of posttranscriptional regulation, which is involved in the synergistic induction of CX3CL1 in response to the combined stimulation with TNF-alpha and IFN-gamma.

[Metastatic renal tumor from oral floor cancer: a case report].

A 61-year-old man with oral floor cancer (adenoid cystic carcinoma, T2N0M1) was treated with systemicc hemotherapy and radiation therapy at the department of dentistry and oral surgery in our hospital. He had three lung metastases and renal tumors detected by screening computed tomography. The oral floor cancer responded to the treatment to achieve partial response. However, lung and renal metastases did not respond to chemotherapy. Then, the patient was referred to our clinic to rule out the possibility of lung metastasis from renal cell carcinoma. Laparoscopic left nephrectomy was performed and pathological examination on the renal lesions revealed adenoid cystic carcinoma, which had identical histopathological features to the oral floor cancer. To our knowledge, this is the first report of metastatic renal tumor from oral floor cancer (adenoid cystic carcinoma).

[A case of submandibular gland cancer in elderly patients showed significant effect by S-1 and intravenous docetaxel chemotherapy concurrent with radiotherapy].

An elderly case of with advanced head and neck cancer treated by intravenous infusion chemotherapy with weekly docetaxel( DOC)and concurrent radiotherapy was reported. The patient was a 77-year-old man. Clinical diagnosis was submandibular gland carcinoma. He was treated by intravenous infusion chemotherapy with weekly DOC and concurrent radiotherapy (total dose 66 Gy). Two months after irradiation, PET-CT showed a partial response (PR). Therefore, chemotherapy of S-1 (80 mg/day) for 2 weeks every 3 weeks was performed. Two months after the end of chemotherapy, PET-CT showed a complete response(CR). This therapy is effective for the treatment of advanced head and neck cancers for elderly inoperable patients.

Evaluation of beam-on time and number of breath-holds using a flattening-filter-free beam with the deep inspiration breath-hold method in left-sided breast cancer.

We performed a dosimetric study to evaluate the benefits of using a flattening-filter-free (FFF) beam with the deep inspiration breath-hold (DIBH) method for left-breast cancer. We used data from 30 previous patients with treatment plans that included DIBH for left-breast cancer with a flattened beam. FFF beam plans were calculated from previous treatment plan images and compared to the original plans in terms of monitor units (MU), number of segments, beam-on time, and breath-holds. Beam-on time was calculated by adding the traveling time of 1.5 second between segments to the time calculated from the MU and dose rate. Breath-holds were calculated based on the beam-on time, assuming 15 s per hold. The FFF beam had increased MU in all cases (mean ± SD: flattened beam, 122.4 ± 9.8 MU; FFF beam, 160.2 ± 17.5 MU). Furthermore, the number of segments increased with the FFF beam in all cases (median [range]: flattened beam, 2 [1 to 3]; FFF beam, 5 [3 to 7]). However, in most cases, the beam-on time was reduced using the FFF beam (mean ± SD: flattened beam, 27.8 ± 7.4 seconds; FFF beam, 13.2 ± 1.7 seconds), although when a 6 MV flattened beam was used there was not a large increase. There were fewer breath-holds in most cases with the FFF beam. Cases using a 4 MV flattened beam also had fewer breath-holds; however, the number of breath-holds was consistent or increased in cases that used a 6 MV flattened beam (median [range]: flattened beam, 3 [1 to 3]; FFF beam, 1 [1 to 2]).

Retinoic acid-inducible gene-I mediates RANTES/CCL5 expression in U373MG human astrocytoma cells stimulated with double-stranded RNA.

Retinoic acid-inducible gene-I (RIG-I) mediates part of the cell signaling in response to viral infection. Polyinosinic-polycytidilic acid (poly IC) is a synthetic double-stranded RNA (dsRNA) and mimics viral infection when applied to cell cultures. The CC chemokine, RANTES (regulated on activation, normal T-cell expressed and secreted), is a potent attractant for inflammatory cells such as memory T-lymphocytes, monocytes and eosinophils. In the present study, we demonstrated that poly IC enhances the expression of RIG-I in U373MG human astrocytoma cells. The RNA interference of RIG-I resulted in the suppression of the poly IC-induced RANTES expression. Pretreatment of the cells with SB203580, an inhibitor of p38 mitogen-activated protein kinase, and dexamethasone inhibited the poly IC-induced expression of RIG-I. Furthermore, poly IC upregulated RIG-I in normal human astrocytes in culture and the in vivo injection of poly IC into the striatum of the mouse brain induced the expression of RIG-I in astrocytes. We conclude that RIG-I may be involved in immune reactions against viral infection, at least in part, through the regulation of RANTES expression in astrocytes.

Expression of retinoic acid-inducible gene-I (RIG-I) in macrophages: possible involvement of RIG-I in atherosclerosis.

AIM: Retinoic acid-inducible gene-I (RIG-I) is one of the genes induced by interferon (IFN)-gamma which plays an important role in atherosclerosis. The aim of this study is to examine if RIG-I is involved in atherosclerosis. METHODS: The expression of RIG-I in atherosclerotic lesions in human aorta was examined by immunohistochemical analysis. The expression of RIG-I in THP-1 monocytic cell line or human monocyte-derived macrophages was studied by western blot and RT-PCR analyses. RESULTS: Intense immunoreactivity for RIG-I was detected in intimal macrophages in atherosclerotic lesions. IFN-gamma slightly enhanced the RIG-I expression in THP-1 cells. Treatment of the cells with phorbol 12-myristate 13-acetate, which induces the differentiation of the cells into macrophage-like cells, significantly enhanced the IFN-gamma -induced RIG-I expression. IFN-gamma also stimulated the expression of RIG-I in monocyte-derived macrophages. CONCLUSION: These results suggest that RIG-I may be involved in differentiation and activation of macrophages, playing a role in atherosclerosis.

Expression of vascular endothelial growth factor by photodynamic therapy with mono-L-aspartyl chlorin e6 (NPe6) in oral squamous cell carcinoma.

Photodynamic therapy (PDT) is a method for treating pre-cancerous and cancerous lesions of the skin, bladder and oral cavity. However, tumour recurrence after PDT remains problematic despite good initial response. Some studies have shown that PDT induces vascular endothelial growth factor (VEGF) expression in human oral squamous cell carcinoma and other organs. However, little is known about VEGF expression applied to PDT in human carcinoma cell lines. No studies have been conducted of PDT using Npe6 (Npe6-mediated PDT), a second-generation photosensitizer, in the human oral carcinoma cell line, HSC-3 cells. We investigated the expression of VEGF, c-jun and c-fos proto-oncogenes in HSC-3 cells in response to Npe6-mediated PDT. We also addressed the possibility that oxidative damage induced by PDT could lead to an angiogenic response, via VEGF expression. Reverse transcription polymerase chain reaction (RT-PCR) analysis revealed that Npe6-mediated PDT induced the expression of mRNAs for VEGF, c-jun and c-fos in time- and concentration-dependent manners. Desferrioxamine (DFX), an iron chelator, induced VEGF expression, but the expression pattern was different to that of Npe6-mediated PDT. The expression mRNAs for VEGF, c-jun and c-fos induced by Npe6-mediated PDT were inhibited by SB203580, p38 MAPK inhibitors, and the expression of VEGF mRNA was inhibited by cycloheximide (CHX), a protein synthesis inhibitor. The c-jun mRNA expression was inhibited, whereas the c-fos mRNA expression was enhanced by N-acetyl-L-cysteine (NAC), a free radical scavenger. We conclude that Npe6-mediated PDT induces the expression of VEGF, c-jun and c-fos in human oral carcinoma cell line, HSC-3 cell, and at least partly, through the activation of p38 MAPK.

Interleukin-1beta enhances the angiotensin-induced expression of plasminogen activator inhibitor-1 through angiotensin receptor upregulation in human astrocytes.

Plasminogen activator inhibitor-1 (PAI-1) regulates not only fibrinolysis but extracellular matrix remodeling, and angiotensin II is known to play an important role in controlling the expression of PAI-1 in astrocytes. We have studied the effect of interleukin-1beta (IL-1beta), one of major cytokines also active in the nervous system, on the angiotensin II-induced expression of PAI-1 in human astrocytes. Cultures of normal human astrocytes were stimulated with IL-1beta and angiotensin II, and the expression of mRNAs for angiotensin II type 1 receptor (AT1) and PAI-1 was analyzed by reverse transcription-polymerase chain reaction (RT-PCR) or real-time quantitative PCR. PAI-1 protein in astrocyte-conditioned medium was measured by enzyme-linked immunosorbent assay (ELISA). IL-1beta enhanced the expression of AT1 in astrocytes in time- and concentration-dependent manners. After 24-h stimulation, 10 ng/ml IL-1beta and 10 nM angiotensin II increased the levels of PAI-1 protein in astrocyte-conditioned medium by 1.9-fold and 1.8-fold of the basal value, respectively. There was no synergistic effect when the cells were stimulated simultaneously with IL-1beta and angiotensin II. When the cells were stimulated, with angiotensin II, 16 h after the stimulation with IL-1beta, the production of PAI-1 was enhanced by 1.4-fold as compared to the cells stimulated only with IL-1beta. CV-11794, an AT1 antagonist, inhibited the enhanced PAI-1 production in response to angiotensin II. We conclude that IL-1beta increases angiotensin II-induced PAI-1 secretion by astrocytes through the induction of AT1, and the enhanced secretion of PAI-1 may modulate functions of plasminogen activators in the nervous system.

Photodynamic therapy with mono-L-aspartyl chlorin e6 can cause necrosis of squamous cell carcinoma of tongue: experimental study on an animal model of nude mouse.

Mono-L-aspartyl chlorin e6 (NPe6) is an effective photosensitizer with a major absorption band at 664 nm. NPe6 is potentially exploitable for photodynamic therapy (PDT) and does not cause the side effect of prolonged normal skin photosensitization. However, there are no clinical and experimental reports of its use in oral cancer till now. In the present study, we examined the effectiveness of NPe6-induced PDT with a diode laser for treatment of tongue cancer in the nude mouse. Six nude mice with experimental tongue cancer (HSC-3) were given 10 mg/kg NPe6 intravenously. Two hours later PDT was performed using a laser diode at a light dose of 100 J/cm2 and wavelength of 664 nm. Histological changes in the tumors were examined 42-72 h after PDT. Almost all of the tumors developed necrosis, while viable-like neoplastic cells remained mainly in the peripheral region of the tumor in some cases. The mean depth of necrosis below the surface was 2.1 mm. The mean tumor thickness below the surface was 2.3 mm. Tumor thickness coincided with the depth of necrosis. NPe6-induced PDT exhibited tumor selectivity and can effectively cause necrosis of tongue cancers. This therapy could be suggested for treatment of other superficial oral cancer.

Platelet-activating factor enhances the expression of nerve growth factor in normal human astrocytes under hypoxia.

Nerve growth factor (NGF) is required for the survival of neurons. We have addressed the effect of platelet-activating factor (PAF), one of the mediators of ischemic injury of the brain, on NGF expression in astrocytes. Normal human astrocytes in culture were stimulated with PAF, and levels of NGF mRNA and protein were analyzed by reverse transcription-polymerase chain reaction (RT-PCR), real-time quantitative PCR and enzyme-linked immunosorbent assay (ELISA). PAF increased the expressions of NGF mRNA and protein in astrocytes in time- and concentration-dependent manners. After 48-h stimulation, 10 nmol/L PAF increased the levels of NGF protein in astrocyte-conditioned medium by 1.4-fold. The PAF-induced stimulation of NGF expression was further enhanced (2.1-fold of the control) in the cells under hypoxic culture condition. BN52021 (Ginkgolide B), an antagonist for PAF binding sites, suppressed the effect of PAF. We conclude that PAF enhances NGF gene expression in human astrocytes, and the PAF-induced increase in the expression of NGF under hypoxia may benefit the protection of the nervous tissue by promoting neuronal survival.

Production of growth related oncogene protein-alpha in human umbilical vein endothelial cells stimulated with soluble interleukin-6 receptor-alpha: role of signal transducers, janus kinase 2 and mitogen-activated kinase kinase.

Growth-related oncogene protein-alpha (GRO-alpha) is a member of the C-X-C chemokine family with a wide variety of biological activities. We studied the production of GRO-alpha by human umbilical vein endothelial cells (HUVEC) in response to the stimulation with soluble form of interleukin-6 receptor alpha (sIL-6R). sIL-6R stimulated HUVEC to express GRO-alpha mRNA and secrete GRO-alpha protein in concentration-and time-dependent manners. The sIL-6R-induced GRO-alpha expression was inhibited by the pretreatment of the cells with AG490, a janus kinase 2 (JAK2) inhibitor, or with U0126, a MAP kinase-ERK kinase (MEK) inhibitor. sIL-6R also induced the phosphorylation of both Src homology 2-protein tyrosine phosphatase-2 (SHP-2), signal transducer and activator of transcription 3 (STAT3) and MEK. AG490 pretreatment inhibited the MEK phosphorylation but did not affect the STAT3 phosphorylation. We conclude that sIL-6R induces GRO-alpha expression in HUVEC through the activation of JAK2 and MEK.

Photodynamic therapy upregulates expression of Mac-1 and generation of leukotriene B(4) by human polymorphonuclear leukocytes.

This study investigated the expression of Mac-1 (CD11b/CD18) and generation of leukotriene B(4) (LTB(4)) by polymorphonuclear leukocytes (PMNs) in response to Mono-L-aspartyl chlorine 6 (NPe6) mediated photodynamic therapy (PDT). PDT was carried out using a laser diode at a light dose of 10 J/cm(2) and wavelength of 664 nm. Expression of Mac-1 was significantly increased about 3-fold by PDT compared with that of Npe6 exposure. The increase in the expression of Mac-1 was not inhibited by 5-lipoxygenase inhibitor (AA861). On the other hand, generation of LTB(4) by PMNs was increased by incubation with NPe6 alone and further promoted by PDT and that was significantly inhibited by AA861. These results suggest that PDT can induce PMNs to express extensively Mac-1 and generate a certain amount of LTB(4) that may play an important cytocidal role in the treatment of oral cancer.

Role of type I- and type II-interferon in expression of melanoma differentiation-associated gene-5 in HSC-3 oral squamous carcinoma cells.

Melanoma differentiation-associated gene 5 (MDA-5) and retinoic acid-inducible gene-I (RIG-I)are members of DExH family of proteins, and known to play important roles in antiviral responses to induce type I interferons (IFNs). MDA-5 has been thought to sense RNA virus with long(>1 kb) double-stranded RNA. However, MDA-5 is also induced by type II IFN that is involved in acquired immunity, suggesting that role of MDA-5 remains to be elucidated. In addition, no study regarding MDA-5 in oral region has been performed. Here we investigated the role of MDA-5 in HCS-3 squamous carcinoma cells derived from oral epithelial cells. Treatment of HCS-3 cells with IFN-α2b or IFN-γ significantly induced MDA-5 as well as RIG-I. IFN-α2b exerted anti-proliferative effect in HSC-3 cells while no such effect was observed in the cells treated with IFN-γ. MDA-5 is known to be associated with tumor cell growth in melanoma. However, overexpression of MDA-5 did not alter the proliferation in HSC-3 cells, indicating that MDA-5 is unrelated to the cell growth in this type of cells. We conclude that MDA-5 is induced by both type I- and type II-IFNs in HSC-3 cells, and this suggests MDA-5 may play a role in immune responses in oral cavity.

Periosteum-derived cells respond to mechanical stretch and activate Wnt and BMP signaling pathways.

The periosteum supplies osteoblasts and nutrients for bone metabolism and is important for osteoblast differentiation and osteogenesis. Recently, periosteum-derived cells have been used for orofacial bone regeneration therapy. However, little is known about the function of the periosteum in physiological bone remodeling. On our hypothesis that the periosteum senses a mechanical stress to induce bone remodeling, we subjected human jaw bone periosteum cells (HJBPCs) to uniaxial stretching for 24 h and characterized their gene expression profiles by microarray analysis. Of62,976 genes detected, 550 genes related to bone metabolism were extracted, and 76 of these genes with large changes in gene expression were short-listed. The results indicated that mechanical stretch in HJBPCs regulated the expression levels of genes involved in the Wingless-type MMTV integration (Wnt) site, bone morphogenetic protein (BMP) signaling pathways, and inflammatory cytokines. We propose that periosteum-derived cells sense mechanical stress and then activate and regulate signals for osteoblast differentiation and osteogenesis.

Color signal integration for color discrimination along a long-range apparent motion trajectory.

In contrast to the classical view that fundamental visual attributes such as color and motion are independently processed in the visual system (e.g. Livingstone and Hubel, 1987; Marr, 1982), recent studies have revealed various forms of cross-attribute interactions, such as averaging of color appearance along the motion trajectory of an object (Nishida et al., 2007). In this study, we investigated whether such color signal integration along a motion trajectory can be induced only by motion mechanisms having large receptive fields, without simple integration within direction-selective neurons with small receptive fields, like those in V1. The stimulus consisted of discs with long-range apparent motion along a circular trajectory. The stimulus onset asynchrony (SOA) between disc presentations controlled the strength of the apparent motion perception. We measured observers' sensitivity in detecting color modulation on the discs. The results showed that the measured sensitivity was lowest at SOAs corresponding to the strongest motion perception. This can be interpreted as follows: color signals were integrated along an apparent motion path, and this integration reduced chromatic sensitivity by averaging color signals. Another experiment that controlled apparent motion perception in a different way also supported this idea. However, this integration effect seemed to be linked to responses of motion detectors for the apparent motion stimuli, not directly to perceptual motion representation in the visual system. These results suggest that the human visual system handles color information from retinal inputs regarding moving objects based not only on a retinotopic coordinate but also on object-based coordinates, even when the moving object yields only long-range apparent motion.

Influence of dentures in the initial occurrence site on the prognosis of bisphosphonate-related osteonecrosis of the jaws: a retrospective study.

OBJECTIVE: This retrospective cohort study was conducted to investigate the influence of wearing dentures in the initial occurrence site of bisphosphonate-related osteonecrosis of the jaws (BRONJ). STUDY DESIGN: A questionnaire regarding the prevalence, therapy, and outcome of jawbone lesions during 2006-08 was mailed to 248 medical institutions with an oral and maxillofacial surgery department in Japan. RESULTS: Ninety-nine patients wearing dentures had significantly shorter duration until occurrence than 151 patients not wearing dentures. In addition, remission of BRONJ affecting the mandibular canine and premolar region in denture-wearing patients was significantly more difficult. Poor oral hygiene status was found to affect significantly the prognosis of BRONJ in denture-wearing patients. Alcohol habit also delayed remission, but high body mass index promoted remission. CONCLUSION: Wearing a denture in the initial occurrence site of BRONJ was shown to influence the prognosis of BRONJ, especially in mandibular denture-wearing patients.

Superselective intra-arterial chemoradiotherapy with docetaxel-nedaplatin for advanced oral cancer.

Cisplatin-based, superselective, intra-arterial chemotherapy concurrent with radiotherapy (SSIACRT) has gained wide acceptance as a common/curative treatment for advanced head and neck cancer. We combined nedaplatin (CDGP) with docetaxel (DOC) as a new combination in SSIACRT for advanced oral squamous cell carcinoma in 2003. Twenty-two patients with advanced oral cancer were treated by radiotherapy (66 Gy) concurrent with superselective intra-arterial DOC (40 mg/body) and CDGP (80 mg/m²) infusion between 2003 and 2009. Complete response was achieved in 18 (81.8%) of the 22 patients. Of the 17 patients with positive neck disease, 16 (94%) were assessed as disease-free. The 5-year overall survival rate was 78.5%, and the major adverse effects were leukocytopenia and mucositis. Five patients (22.7%) developed distant metastases post-treatment. These results indicate that intra-arterial docetaxel-nedaplatin infusion concurrent with radiotherapy is efficacious for advanced oral cancer. The side effects are easily manageable, and the most important outcome of the treatment is the preservation of patients' quality of life (QOL) and improved prognosis.