Monocomponent chemoembolization in oral and oropharyngeal cancer using an aqueous crystal suspension of cisplatin.
Intensification of intra-arterial chemotherapy with high-dose cisplatin and concomitant reduction of toxicity under the conditions of the head and neck was aimed at by combination of antineoplastic activity and embolizing effect in the same pharmacon. A cisplatin suspension in normal saline (5 mg in 1 ml) with precipitation of microembolizing cisplatin crystals was prepared. No additional pharmacons. Cisplatin dosage was 150 mg m(-2), maximum absolute dose 300 mg, maximum amount of fluid 60 ml. Thirty patients (UICC-Classification of tumours: I/2 patients, II/6, III/2; IV/20) were treated in a neoadjuvant setting with superselective chemoembolization using the cisplatin suspension. A control group (n=30) with the same tumour and nodal staging was treated with a usual cisplatin solution (150 mg m(-2) dissolved in 500 ml saline). In both groups, parallel intravenous infusion of sodium thiosulphate (9 g m(-2)). Endpoints were toxicity and response. Continuation of treatment by surgery or radiation. Overall remission was 70% in the study group and 46.7% in the control group after one cycle respectively. Systemic side-effects were very low (grade I WHO) in both groups. Side-effects were found to be similar to post-embolization syndrome (swelling, mild to moderate pain, leucocytosis without fever) in the study group. Chemoembolization in the head and neck area can be carried out routinely using this method.
Kovács
A F
AF
Clinic for Maxillofacial Plastic Surgery, Johann Wolfgang Goethe-University Medical School, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. A.Kovacs@em.uni-frankfurt.de
Obitz
P
P
Wagner
M
M
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D002626:Chemistry, Pharmaceutical; D016461:Chemoembolization, Therapeutic; D002945:Cisplatin / Q000008:administration & dosage* / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000628:therapy*; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D002945:Cisplatin