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Intratumor cisplatin nephrotoxicity in combined laser‐induced thermal therapy for cancer treatment
Author(s) -
Palumbo Marcel N.,
Cervantes Onivaldo,
Eugênio Cecilia,
Hortense Flávia T. P.,
Ribeiro João C.,
Paolini Ana Amélia P.,
Tedesco Antônio C.,
Sercarz Joel A.,
Paiva Marcos B.
Publication year - 2017
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.22685
Subject(s) - medicine , nephrotoxicity , creatinine , cisplatin , head and neck cancer , renal function , urology , cancer , surgery , chemotherapy , kidney
Thermal ablation of tumors by Nd:YAG laser has been growing as a multidisciplinary subspecialty defined as laser‐induced thermal therapy (LITT), and has been increasingly accepted as a minimally invasive method for palliation of advanced or recurrent cancer. Previous studies have shown that adjuvant chemotherapy can potentiate laser thermal ablation of tumors leading to improved palliation in advanced cancer patients. Objective Evaluate nephrotoxicity by early markers of renal function in treating head and neck cancer using intra‐tumor injections of cisplatin combined with laser‐induced thermal therapy (CDDP‐LITT). Methods Nine patients with recurrent head and neck tumors were treated by CDDP‐LITT in order to determine nephrotoxicity related to this synergistic association. Among the tests requested to detect early were creatinine, magnesium, creatinine clearance, serum urea‐BUN, type I urine, and proteinuria at 24 hours. Results Twelve recurrent tumors in nine patients were treated by CDDP‐LITT. Pain was the major complaint (four patients), while other symptoms included dysphagia, dyspnea, bleeding, and difficulties in chewing. Fifteen laser procedures were performed and maximal CDDP dose was 50 mg. None of the markers for nephrotoxicity showed changes at these levels of CDDP intra‐tumor injections. Conclusion This initial experience with (CDDP‐LITT) indicates both safety and therapeutic potential for palliation of advanced head and neck cancer. However, safety and feasibility must be confirmed by longer follow‐up and further escalation of CDDP doses in a Phase I study to determine maximum tolerated dose (MTD) and demonstrate tangible benefits for patients. Lasers Surg. Med. 49:756–762, 2017. © 2017 Wiley Periodicals, Inc.