Rapid superselective high-dose cisplatin infusion for advanced head and neck malignancies.

Abstract

Advances in vascular radiology techniques for superselective arterial infusions and methods to overcome systemic toxicity from high-dose cisplatin chemotherapy encouraged us to reevaluate the effects of rapid regional cisplatin infusion for patients with head and neck malignancies. Twenty patients (17 carcinomas, three sarcomas) received high-dose cisplatin (100-200 mg/m2) by this method. Fifteen of the 17 patients with upper aerodigestive tract carcinoma are part of an ongoing phase I dose escalation of cisplatin with sodium thiosulfate neutralization. Three additional patients with sarcomas were treated with intra-arterial (IA) cisplatin and systemic Adriamycin. Fifty-three IA infusions were performed without any complications. Only minimal toxicity related to the chemotherapy was observed. The overall response rate for previously untreated patients was nine of 10 (90%) [complete response (CR) 67%; partial response (PR) 33%]. The response rate for patients with recurrent disease was five of eight (63%) (CR 20%, PR 80%). The average length of follow-up is 9.5 months and the actuarial survival rate is 56%. Superselective rapid infusion of high-dose cisplatin for patients with advanced head and neck malignancies is feasible, relatively nontoxic, and may have important applications in multimodality therapy, particularly for patients with bulky primary disease.

• Authors: K T Robbins, A M Storniolo, C Kerber, S Seagren, A Berson, S B Howell
• Journal: Head & neck (Head Neck) 1992 Sep-Oct Vol. 14 Issue 5 Pg. 364-71 ISSN: 1043-3074 [Print] United States
• PMID: 1399569 (Publication Type: Journal Article)

Chemical References

• Antidotes
• Thiosulfates
• Doxorubicin
• sodium thiosulfate
• Cisplatin

Topics

• Antidotes (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Carcinoma (drug therapy, mortality, radiotherapy, surgery)
• Cisplatin (administration & dosage, adverse effects, therapeutic use)
• Combined Modality Therapy
• Dose-Response Relationship, Drug
• Doxorubicin (administration & dosage)
• Feasibility Studies
• Head and Neck Neoplasms (drug therapy, mortality, radiotherapy, surgery)
• Humans
• Infusions, Intra-Arterial (methods)
• Sarcoma (drug therapy, mortality)
• Survival Rate
• Thiosulfates (administration & dosage)