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Selective (intra-arterial), rapid infusion chemo-radiotherapy to preserve the larynx in advanced laryngeal carcinoma: preliminary results

Published online by Cambridge University Press:  22 May 2009

T Nakashima ,
T Mihoki ,
T Ono ,
H Umeno  and
N Tanaka
T Nakashima*
Affiliation:
Department of Otolaryngology-Head and Neck SurgeryKurume University School of Medicine, Kurume, Japan
T Mihoki
Affiliation:
Department of Otolaryngology-Head and Neck SurgeryKurume University School of Medicine, Kurume, Japan
T Ono
Affiliation:
Department of Otolaryngology-Head and Neck SurgeryKurume University School of Medicine, Kurume, Japan
H Umeno
Affiliation:
Department of Otolaryngology-Head and Neck SurgeryKurume University School of Medicine, Kurume, Japan
N Tanaka
Affiliation:
Department of Radiology, Kurume University School of Medicine, Kurume, Japan
*
Address for correspondence: Dr Tadashi Nakashima, Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. Fax: +81 942 37 1200, E-mail: [email protected]
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Abstract

Objectives:

We had previously treated patients with advanced stage laryngeal cancer by laryngectomy with or without post-operative radiotherapy. In order to improve such patients' quality of life, we sought to preserve the larynx by selective (intra-arterial), rapid infusion chemotherapy combined with radiotherapy.

Methods:

Chemotherapy was administered intra-arterially in the angiography suite via transfemoral catheterisation of the superior thyroid artery. Patients received up to four once-weekly infusions of cisplatin (75 mg/patient) with simultaneous intravenous administration of sodium thiosulphate, a neutralising agent. Patients also received external radiation simultaneously at a dose of 1.8 or 2.0 Gy per fraction, once daily for five days a week for 7 weeks.

Results:

Intra-arterial infusion chemo-radiotherapy was performed in eight patients with advanced laryngeal carcinoma (four glottic, three supraglottic and one subglottic type carcinoma). A complete response was achieved at the primary site and at lymph node metastases in all eight patients. Overall toxic side effects were modest. No catheter-related thrombo-embolic complications were observed during any of the chemotherapy sessions.

Conclusions:

Selective (intra-arterial), rapid infusion chemo-radiotherapy may enable laryngeal preservation in patients with advanced laryngeal carcinoma.

Keywords

Laryngeal CancerSelective Arterial Infusion TherapyLarynx Preservation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Supplement S31 , May 2009 , pp. 30 - 34
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Chevalier, D, Laccourreye, O, Brasnu, D, Laccourreye, H, Piquet, JJ. Cricohyoidoepiglottopexy for glottic carcinoma with fixation or impaired motion of the true vocal cord: 5-year oncologic results with 112 patients. Ann Otol Rhinol Laryngol 1997;106:364–9CrossRefGoogle ScholarPubMed
2Laccourreye, O, Brasnu, D, Perie, S, Muscatello, L, Menard, M, Weinstein, G. Supracricoid partial laryngectomies in the elderly: mortality, complications, and functional outcome. Laryngoscope 1998;108:237–42CrossRefGoogle ScholarPubMed
3Nakayama, M, Okamoto, M, Miyamoto, S, Takeda, M, Yokobori, S, Masaki, T et al. Supracricoid laryngectomy with cricohyoidoepiglotto-pexy or cricohyoid-pexy: experience on 32 patients. Auris Nasus Larynx 2008;35:77–82CrossRefGoogle ScholarPubMed
4Laccourreye, H, Laccourreye, O, Weinstein, G, Menard, M, Brasnu, D. Supracricoid laryngectomy with cricohyoidoepiglottopexy: a partial laryngeal procedure for glottic carcinoma. Ann Otol Rhinol Laryngol 1990;99:421–6CrossRefGoogle ScholarPubMed
5Myers, EN, Alvi, A. Management of carcinoma of the supraglottic larynx: evolution, current concepts, and future trends. Laryngoscope 1996;106:559–67CrossRefGoogle ScholarPubMed
6Forastiere, AA, Goepfert, H, Maor, M, Pajak, TF, Weber, R, Morrison, W et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091–8Google Scholar
7The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;324:1685–90Google Scholar
8Genden, EJ, Ferlito, A, Rinoldo, A, Silver, C, Fagan, JJ, Suarez, C et al. Recent changes in the treatment of patients with advanced laryngeal cancer. Head Neck 2007;30:103–10CrossRefGoogle Scholar
9Reidenbach, MM. The paraglottic space and transglottic cancer. Anatomical considerations. Clinical Anat 1996;9:244–513.0.CO;2-E>CrossRefGoogle ScholarPubMed
10Pressman, JJ, Sermon, MB, Monell, C. Anatomical studies related to the dissemination of cancer of the larynx. Trans Am Acad Ophthalmol Otolaryngol 1960;64:628–38Google Scholar
11Robbins, KT, Staniolo, AM, Kerber, C, Seagren, S, Berson, A, Howell, SB. Rapid superselective high dose cisplatin infusion for advanced head and neck malignancies. Head Neck 1992;14:364–71CrossRefGoogle ScholarPubMed
12Robbins, KT, Vicario, D, Seagren, S, Weisman, R, Pellitteri, P, Kerber, C, Orloff, L, Los, G, Howell, SB. A targeted supradose cisplatin chemoradiation protocol for advanced head and neck cancer. Am J Surg 1994;168:419–22CrossRefGoogle ScholarPubMed
13Robbins, KT, Kumar, P, Regine, WF, Wong, FSH, Weir, AB 3rd, Flick, P et al. Efficacy of targeted superdose cisplatin and concomitant radiation therapy for advanced head and neck cancer: the Memphis experience. Int J Radiat Oncol Biol Phys 1997;38:263–71Google Scholar
14Los, G, Blommaert, FA, Barton, T, Heath, DD, Den Engelse, L, Hanchett, C, Vicario, D, Weisman, R, Robbins, KT, Howell, SB. Selective intra-arterial infusion of high dose cisplatin in advanced head and neck cancer patients results in high tumor platinum concentrations and cisplatin-DNA adduct formation. Can Chemo Pharm 1995;37:150–4CrossRefGoogle ScholarPubMed
15Cheung, DK, Regan, J, Savin, M, Gibberman, V, Woessner, W. A pilot study of intra-arterial chemotherapy with cisplatin in locally advanced head and neck cancers. Cancer 1988;61:903–8Google Scholar
16Lee, YY, Dimery, IW, Van Tassel, P, De Pena, C, Blacklock, JB, Goepfert, H. Superselective intra-arterial chemotherapy of advanced paranasal sinus tumors. Arch Otolaryngol Head Neck Surg 1989;115:503–11CrossRefGoogle ScholarPubMed
17Samant, S, Robbins, T, Vang, M, Wan, J, Robertson, J. Intra-arterial cisplatin and concomitant radiation therapy followed by surgery for advanced paranasal sinus cancer. Arch Otolaryngol Head Neck Surg 2004;130:948–55Google Scholar