Effects of intralesional 32-P chromic phosphate in refractory patients with head and neck tumours.
BACKGROUND
The clinical outcome of refractory head and neck (H&N) cancer patients remains poor despite novel treatment strategies. In this pilot study the efficacy of intratumoral injection of 32-P chromic phosphate in 14 patiehts with refractory H&N carcinomas was investigated in terms of response rates and overall survival.


METHODS
Fourteen patients (median age: 59 years) with either cytostatic drug-resistant tumours or tumours known to be primarily chemotherapy-resistant were entered into the study. After sonographic determination of the tumour volume, 32-P chromic phosphate (74-444 MBq) was injected into the central part of the tumour under sonographic guidance. Follow-up investigations included serial scintigraphy, sonographic examinations and hematological studies.


RESULTS
Injection of 32-P chromic phosphate into refractory H&N tumours resulted in remarkable regression. The median survival of all patients was 7.8 months (range: 4-16). Eight patients exhibited a partial response, while 6 patients did not respond to the treatment. In 3 patients thrombocytopenia (grade I/II) was observed, but no other significant side-effects were apparent. Significant pathological and anatomical changes within the tumour tissue were demonstrated. In all cases examined, formation of a cyst within the area of central activity, surrounded by a centrifugal necrotic ring and a marginal fibrotic structure, was found.


CONCLUSIONS
A lack of persistent systematic or local side-effects, as well as noteworthy efficacy, are properties of this novel regional treatment modality with 32-P chromic phosphate. This modality deserves consideration for further clinical trials.
Alimi
Kyrus A
KA
Department of Medical Oncology and Hematology, Elisabeth Hospital, Roentgenstrasse 10, D-45661 Recklinghausen, Germany.
Firusian
Nosrat
N
Dempke
Wolfram
W
D000328:Adult; D000368:Aged; D017608:Chromium Compounds / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D015552:Injections, Intralesional; D008875:Middle Aged; D010710:Phosphates / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D019275:Radiopharmaceuticals / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D015996:Survival Rate
D017608:Chromium Compounds; D010710:Phosphates; D019275:Radiopharmaceuticals; C509370:chromic phosphate, 32P-labeled