Incidence and Characteristics of Infectious Complications During Superselective Intra-Arterial Chemoradiotherapy for Oral Squamous Cell Carcinoma: A Systematic Review

Abstract

Superselective intra-arterial chemoradiotherapy (SSIACRT) is an organ-preserving treatment modality for oral squamous cell carcinoma (OSCC); however, infectious complications related with this sort of treatment remain badly characterized. This systematic review tried to evaluate the available evidence about infectious complications following SSIACRT for OSCC and to synthesize indirect evidence where direct literature was limited. A systematic search of the literature identified 23 eligible studies. Due to the very small amount of studies only investigating infectious complications following SSIACRT in OSCC, the included evidence was organized into three evidence tables: studies evaluating infectious complications of intra-arterial chemoradiotherapy across various malignancies (n = 10), studies discussing infectious complications in OSCC treated using various therapeutic modalities (n = 10), and studies specifically investigating infectious complications following SSIACRT for OSCC (n = 3).

Inside the included studies, reported infectious complications included catheter-related bloodstream infections, catheter-site infections, pneumonia, febrile neutropenia, oral candidiasis, surgical-site infections, osteomyelitis, and sepsis. Management primarily consisted of antimicrobial therapy, catheter removal or replacement if appropriate, surgical intervention, and supportive care. The limited number of studies directly addressing SSIACRT in OSCC shows a massive gap in the current literature. Comparative synthesis of the three evidence tables suggests that while SSIACRT gives many therapeutic advantages, infectious complications remain an important but underreported aspect of patient management. More prospective studies with standardized reporting are required to more goodly define the incidence, risk factors, management strategies, and long-term outcomes of infectious complications in this patient population.