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Rapid superselective high‐dose cisplatin infusion with concomitant radiotherapy for advanced head and neck cancer
Author(s) -
Homma Akihiro,
Furuta Yasushi,
Suzuki Fumiyuki,
Oridate Nobuhiko,
Hatakeyama Hiromitsu,
Nagahashi Tatsumi,
Ushikoshi Satoshi,
Asano Takeshi,
Nishioka Takeshi,
Shirato Hiroki,
Fukuda Satoshi
Publication year - 2005
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20116
Subject(s) - medicine , concomitant , mucositis , nausea , vomiting , radiation therapy , surgery , head and neck cancer , cisplatin , toxicity , progressive disease , chemotherapy
Purpose. The purpose of this study was to evaluate the efficacy of rapid superselective high‐dose cisplatin infusion with concomitant radiotherapy for previously untreated patients with advanced head and neck cancer. Methods. Forty‐three patients for whom surgery was contraindicated or who rejected radical surgery were given superselective intra‐arterial infusions of cisplatin (100–120 mg/m 2 /week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and conventional extra‐beam radiotherapy (65 Gy/26 f/6.5 weeks). Results. Thirty‐nine patients had stage IV disease, and the remaining four had stage III disease. During the median follow‐up period of 21 months, the 3‐year locoregional progression‐free rates of all patients ( n = 43) and patients with unresectable disease ( n = 24) were 68.9% and 56.4%, respectively. In addition, the 3‐year overall survival of all patients and patients with unresectable disease was 54.0% and 39.6%, respectively. Thirty‐five patients (81.4%) experienced nonhematologic grade III to IV toxicity, including mucositis ( n = 16), nausea/vomiting ( n = 8), and neurologic signs ( n = 2). No patient died as a result of treatment toxicity. There are 29 surviving patients without evidence of disease, all of whom are able to have oral intake without feeding‐tube support. Conclusions. We confirmed the efficacy of superselective arterial infusion and concomitant radiotherapy, which can concentrate the attack of supradose cisplatin on locoregional disease. Even patients with unresectable disease can be cured. Further studies are needed to establish the indications, long‐term outcome, and possible late side effects of this treatment. © 2004 Wiley Periodicals, Inc. Head Neck 27: 65–71, 2005