Superselective intra-arterial infusion of cisplatin and concomitant radiation therapy (RADPLAT) using gadolinium-based contrast agent in a patient with severe iodine allergy: A case report

Maxillary sinus squamous cell carcinoma (MS-SCC) is a rare malignancy that is often diagnosed at an advanced stage. We report a case of locally advanced MS-SCC that was successfully treated with super-selective intra-arterial cisplatin infusion concurrent with radiotherapy (RADPLAT) using gadolinium-based contrast agents due to a severe allergy to iodinated contrast media. Despite limitations in image quality, gadolinium-based contrast agents enable sufficient visualization with digital subtraction angiography and computed tomography angiography. Seven treatment sessions were completed without adverse events, using a maximum gadolinium dose of 28 mL per session. Post-treatment imaging revealed no residual tumors. This case illustrates the feasibility of using gadolinium-based contrast agents as an alternative to iodinated contrast media for angiographic guidance during RADPLAT in patients with contraindications to iodinated contrast. However, its long-term safety warrants further investigation.