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

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.

• Authors: T Nakashima, T Mihoki, T Ono, H Umeno, N Tanaka
• Journal: The Journal of laryngology and otology. Supplement (J Laryngol Otol Suppl) Issue 31 Pg. 30-4 ( 2009) ISSN: 0144-2945 [Print] England
• PMID: 19460201 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antidotes
• Antineoplastic Agents
• Thiosulfates
• sodium thiosulfate
• Cisplatin

Topics

• Adult
• Aged
• Aged, 80 and over
• Antidotes (administration & dosage)
• Antineoplastic Agents (administration & dosage)
• Cisplatin (administration & dosage)
• Combined Modality Therapy (methods)
• Female
• Humans
• Infusions, Intra-Arterial (methods)
• Laryngeal Neoplasms (drug therapy, radiotherapy)
• Larynx (blood supply)
• Male
• Middle Aged
• Thiosulfates (administration & dosage)
• Thyroid Gland (blood supply)
• Treatment Outcome
• Voice Quality (radiation effects)