Intratumor injections of cisplatin and laser thermal therapy for palliative treatment of recurrent cancer.
OBJECTIVE
The aim of this work was to report initial findings on the clinical application of intratumor injection of cisplatin in a gel (CDDP/gel) combined with laser-induced thermal therapy (LITT) for cancer treatment in a single patient with advanced stage disease.


BACKGROUND
LITT with the neodymium:yttriumaluminum- garnet (Nd:YAG) laser via fiberoptics is a precise, minimally invasive alternative for thermoablation of unresectable or recurrent head and neck neoplasms, but recurrence is often seen at the treatment margins. Combining intratumor chemotherapy with interstitial laser should be most effective using drugs with thermally enhanced toxicity, such as cisplatin. The CDDP/gel therapeutic implant was expected to retain a higher concentration of cisplatin in the tumor margins for improved LITT treatment of the patient presented.


METHODS
In this case report, the cisplatin dose was 0.25 mL gel/cm(3) tumor volume (20 mg of CDDP) followed by LITT (Nd:YAG laser, 50 W, PD = 2,200 J/cm(2)) after the chemotherapy session.


RESULTS
The patient responded with local tumor eradication, and no signs of systemic toxicity were observed related to this therapy. However, the patient developed progressive metastatic disease in the lungs and died 2.5 months later.


CONCLUSIONS
This is a report of a patient with an accessible solid tumor who was treated with intratumor injection of CDDP/gel followed by LITT, which proved to be feasible. Based on preclinical evidence obtained at UCLA and the results of this study, we are encouraged to continue our refinement of LITT combined with chemotherapy for cancer treatment.
Paiva
Marcos B
MB
Department of Surgery, Division of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, 90095-1624, USA. mpaiva@mednet.ucla.edu
Bublik
Michael
M
Castro
Dan J
DJ
Udewitz
Matthew
M
Wang
Marilene B
MB
Kowalski
Luis Paulo
LP
Sercarz
Joel
J
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D005005:Ethmoid Sinus; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D015552:Injections, Intralesional; D053685:Laser Therapy; D008545:Melanoma / Q000628:therapy; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D010166:Palliative Care; D010255:Paranasal Sinus Neoplasms / Q000628:therapy
D000970:Antineoplastic Agents; D002945:Cisplatin