Selective (intra-arterial), rapid infusion chemo-radiotherapy to preserve the larynx in advanced laryngeal carcinoma: preliminary results.
OBJECTIVE
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.
Nakashima
T
T
Department of Otolaryngology-Head and Neck Surgery Kurume University School of Medicine, Kurume, Japan. orlkaku@med.kurume-u.ac.jp
Mihoki
T
T
Ono
T
T
Umeno
H
H
Tanaka
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000931:Antidotes / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D007830:Larynx / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D013885:Thiosulfates / Q000008:administration & dosage; D013961:Thyroid Gland / Q000098:blood supply; D016896:Treatment Outcome; D014833:Voice Quality / Q000528:radiation effects
D000931:Antidotes; D000970:Antineoplastic Agents; D013885:Thiosulfates; C017717:sodium thiosulfate; D002945:Cisplatin