Platinum concentration in sentinel lymph nodes after preoperative intra-arterial cisplatin chemotherapy targeting primary tongue cancer.
CONCLUSIONS
We conclude that intra-arterially injected cisplatin passed via lymph flow into sentinel nodes (SNs) as the platinum concentration in the SNs was higher than that in the non-sentinel nodes (NSNs). It is possible that preoperative intra-arterial chemotherapy targeting primary cancer also has a therapeutic effect on subclinical metastatic SNs.


OBJECTIVE
Intra-arterial chemoradiotherapy has been reported to be effective against not only primary tumors but also nodal metastases. We considered the hypothesis that intra-arterially injected cisplatin passed via lymph flow into regional nodes. This study aimed to investigate intra-arterially injected cisplatin distribution to regional nodes by comparing platinum concentrations in SNs and NSNs.


METHODS
Five patients with T1-2 N0 tongue cancer were treated with preoperative intra-arterial chemotherapy (cisplatin, 100 mg/m(2)) targeting primary cancer. Partial glossectomy together with SN biopsy and elective neck dissection were performed 2 weeks after intra-arterial chemotherapy. Platinum concentrations in the lymph nodes were measured using a Zeeman atomic absorption spectrometer.


RESULTS
Thirteen SNs were harvested together with eight NSNs from the areas adjacent to the SNs. Platinum concentrations were then measured, revealing a significant difference in platinum concentration between the SNs and the NSNs (mean ± SD, 0.682 ± 0.246 µg/g vs 0.506 ± 0.274 µg/g; p = 0.049).
Department of Otolaryngology-Head & Neck Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. t-sakashita@med.hokudai.ac.jp
Tomohiro
T
Sakashita
Akihiro
A
Homma
Nobuhiko
N
Oridate
Seigo
S
Suzuki
Hiromitsu
H
Hatakeyama
Satoshi
S
Kano
Takatsugu
T
Mizumachi
Daisuke
D
Yoshida
Noriyuki
N
Fujima
Satoshi
S
Fukuda
D000328:Adult; D000369:Aged, 80 and over; D002945:Cisplatin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005260:Female; D005500:Follow-Up Studies; D005927:Glossectomy / Q000379:methods; D006801:Humans; D007261:Infusions, Intra-Arterial; D008198:Lymph Nodes / Q000737:chemistry* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010984:Platinum / Q000032:analysis*; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D012494:Sampling Studies; D021701:Sentinel Lymph Node Biopsy; D014062:Tongue Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
D010984:Platinum; D002945:Cisplatin