title: Neoadjuvant intra-arterial chemotherapy in advanced laryngeal and hypopharyngeal cancer.
abstract: OBJECTIVE
  To investigate whether neoadjuvant intra-arterial chemotherapy down-stages the tumors and predicts ultimate outcome in patients with advanced laryngeal and hypopharyngeal cancer.
  
  
  METHODS
  Fifteen patients with stage III and IV cancers received two cycles of intra-arterial cisplatin (40 mg/m(2)) at days 1 and 15, infused super-selectively into superior thyroid artery. Interim evaluation using RECIST 1.1 and volumetry was done in all patients at day 25. Subsequently, the patients received concurrent chemoradiotherapy or surgery with radiotherapy. Final evaluation was done in 10 patients.
  
  
  RESULTS
  At interim evaluation, five patients qualified as responders. Partial response, stable disease and progressive disease rates were 40, 33 and 27%, respectively. At final evaluation, complete response was noted in all patients.
  
  
  CONCLUSIONS
  At interim evaluation, the response rates were lower compared to intravenous neoadjuvant chemotherapy and response to intra-arterial chemotherapy did not predict the ultimate outcome. Thus neoadjuvant intra-arterial chemotherapy offers no advantage over concurrent chemoradiotherapy.
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ashu Seith
authors.initials: AS
authors.lastname: Bhalla
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Thulkar
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Atin
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bidhu Kalyan
authors.initials: BK
authors.lastname: Mohanti
authors.affiliation: Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Thakar
authors.affiliation: Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Atul
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Vishnubhatla
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D059248:Chemoradiotherapy / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D007261:Infusions, Intra-Arterial; D007822:Laryngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D012074:Remission Induction
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: chemotherapy; cisplatin; intra-arterial chemotherapy; laryngeal cancer; neoadjuvant