Superselective high-dose cisplatin infusion with concomitant radiotherapy in patients with advanced cancer of the nasal cavity and paranasal sinuses: a single institution experience.
BACKGROUND
The current study aimed to evaluate the efficacy of superselective high-dose cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with advanced cancer of the nasal cavity and paranasal sinuses.


METHODS
Between October 1999 and December 2006, 47 patients were given superselective intra-arterial infusions of cisplatin (100-120 mg/m2 per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional external-beam radiotherapy (65-70 grays).


RESULTS
There were 7 patients (14.9%) diagnosed with T3, 22 (46.8%) with T4a, and 18 (38.3%) with T4b disease. During the median follow-up period of 4.6 years, the 5-year local progression-free survival rate was 78.4% for all patients (n=47), 69.0% for patients with T4b disease (n=18), and 83.2% for patients with <T4b disease (n=29). The 5-year overall survival rate was 69.3% for all patients, 61.1% for patients with T4b disease, and 71.1% for patients with <T4b disease. RADPLAT was feasible in 45 patients (95.7%). No patient died as a result of treatment toxicity or had a cerebrovascular accident. Osteonecrosis (n=7), brain necrosis (n=2), and ocular/visual problems (n=16) were observed as late adverse reactions.


CONCLUSIONS
Although a single institution experience, the results of the current study suggest that RADPLAT can cure the majority of patients with advanced cancer of the nasal cavity and paranasal sinuses, as well as preserve organs. Late adverse reactions should be monitored in future studies.
Homma
Akihiro
A
Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. ak-homma@med.hokudai.ac.jp
Oridate
Nobuhiko
N
Suzuki
Fumiyuki
F
Taki
Shigenari
S
Asano
Takeshi
T
Yoshida
Daisuke
D
Onimaru
Rikiya
R
Nishioka
Takeshi
T
Shirato
Hiroki
H
Fukuda
Satoshi
S
D000328:Adult; D000368:Aged; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D009364:Neoplasm Recurrence, Local; D009669:Nose Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D010255:Paranasal Sinus Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D016019:Survival Analysis; D013885:Thiosulfates / Q000008:administration & dosage
D013885:Thiosulfates; D002945:Cisplatin