Intra-arterial chemoradiotherapy for head and neck cancer.
Intra-arterial chemotherapy has been used to treat localized malignant neoplasms in patients with head and neck cancer for over 50 years as the head and neck region is particularly well suited to regional chemotherapy. Early intra-arterial chemotherapy did not prove its efficacy. In addition, the additional complications associated with establishing and maintaining arterial access have further dampened enthusiasm for this approach. Subsequent significant advances in vascular radiology techniques and the development of new devices, such as fluoroscopy units and angiographic catheters, have made possible safe, accurate and repeated superselective intra-arterial chemotherapy. Intra-arterial infusion of high-dose cisplatin with systemic neutralization by intravenous sodium thiosulfate (RADPLAT) is a theoretically attractive approach to the treatment of advanced head and neck cancer. However, a Dutch trial comparing intra-arterial and intravenous chemoradiotherapy for advanced head and neck cancer showed that RADPLAT was not superior to intravenous chemoradiotherapy. Therefore, further investigation of RADPLAT, including the refinement of the indications for its application, is needed.
Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine ak-homma@med.hokudai.ac.jp.
Akihiro
A
Homma
Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo.
Rikiya
R
Onimaru
Division of Head and Neck Surgery, Miyagi Cancer Center, Sendai, Japan.
Kazuto
K
Matsuura
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, IL, USA.
K Thomas
KT
Robbins
Department of Otolaryngology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
Masato
M
Fujii
D059248:Chemoradiotherapy / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects; D002986:Clinical Trials as Topic; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial; D007564:Japan; D008875:Middle Aged; D020011:Protective Agents / Q000008:administration & dosage; D013885:Thiosulfates / Q000008:administration & dosage*
D020011:Protective Agents; D013885:Thiosulfates; C017717:sodium thiosulfate; D002945:Cisplatin
chemoradiotherapy; head and neck cancer; intra-arterial; maxillary sinus cancer