Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-20T03:08:10.727Z Has data issue: false hasContentIssue false
  • English
  • Français

Selective (intra-arterial), rapid infusion chemo-radiotherapy to preserve the larynx in advanced laryngeal carcinoma: preliminary results

Published online by Cambridge University Press:  22 May 2009

T Nakashima ,
T Mihoki ,
T Ono ,
H Umeno  and
N Tanaka
T Nakashima*
Affiliation:
Department of Otolaryngology-Head and Neck SurgeryKurume University School of Medicine, Kurume, Japan
T Mihoki
Affiliation:
Department of Otolaryngology-Head and Neck SurgeryKurume University School of Medicine, Kurume, Japan
T Ono
Affiliation:
Department of Otolaryngology-Head and Neck SurgeryKurume University School of Medicine, Kurume, Japan
H Umeno
Affiliation:
Department of Otolaryngology-Head and Neck SurgeryKurume University School of Medicine, Kurume, Japan
N Tanaka
Affiliation:
Department of Radiology, Kurume University School of Medicine, Kurume, Japan
*
Address for correspondence: Dr Tadashi Nakashima, Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan. Fax: +81 942 37 1200, E-mail: orlkaku@med.kurume-u.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

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.

Keywords

Laryngeal CancerSelective Arterial Infusion TherapyLarynx Preservation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Supplement S31 , May 2009 , pp. 30 - 34
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Chevalier, D, Laccourreye, O, Brasnu, D, Laccourreye, H, Piquet, JJ. Cricohyoidoepiglottopexy for glottic carcinoma with fixation or impaired motion of the true vocal cord: 5-year oncologic results with 112 patients. Ann Otol Rhinol Laryngol 1997;106:364–9CrossRefGoogle ScholarPubMed
2Laccourreye, O, Brasnu, D, Perie, S, Muscatello, L, Menard, M, Weinstein, G. Supracricoid partial laryngectomies in the elderly: mortality, complications, and functional outcome. Laryngoscope 1998;108:237–42CrossRefGoogle ScholarPubMed
3Nakayama, M, Okamoto, M, Miyamoto, S, Takeda, M, Yokobori, S, Masaki, T et al. Supracricoid laryngectomy with cricohyoidoepiglotto-pexy or cricohyoid-pexy: experience on 32 patients. Auris Nasus Larynx 2008;35:77–82CrossRefGoogle ScholarPubMed
4Laccourreye, H, Laccourreye, O, Weinstein, G, Menard, M, Brasnu, D. Supracricoid laryngectomy with cricohyoidoepiglottopexy: a partial laryngeal procedure for glottic carcinoma. Ann Otol Rhinol Laryngol 1990;99:421–6CrossRefGoogle ScholarPubMed
5Myers, EN, Alvi, A. Management of carcinoma of the supraglottic larynx: evolution, current concepts, and future trends. Laryngoscope 1996;106:559–67CrossRefGoogle ScholarPubMed
6Forastiere, AA, Goepfert, H, Maor, M, Pajak, TF, Weber, R, Morrison, W et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091–8Google Scholar
7The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;324:1685–90Google Scholar
8Genden, EJ, Ferlito, A, Rinoldo, A, Silver, C, Fagan, JJ, Suarez, C et al. Recent changes in the treatment of patients with advanced laryngeal cancer. Head Neck 2007;30:103–10CrossRefGoogle Scholar
9Reidenbach, MM. The paraglottic space and transglottic cancer. Anatomical considerations. Clinical Anat 1996;9:244–513.0.CO;2-E>CrossRefGoogle ScholarPubMed
10Pressman, JJ, Sermon, MB, Monell, C. Anatomical studies related to the dissemination of cancer of the larynx. Trans Am Acad Ophthalmol Otolaryngol 1960;64:628–38Google Scholar
11Robbins, KT, Staniolo, AM, Kerber, C, Seagren, S, Berson, A, Howell, SB. Rapid superselective high dose cisplatin infusion for advanced head and neck malignancies. Head Neck 1992;14:364–71CrossRefGoogle ScholarPubMed
12Robbins, KT, Vicario, D, Seagren, S, Weisman, R, Pellitteri, P, Kerber, C, Orloff, L, Los, G, Howell, SB. A targeted supradose cisplatin chemoradiation protocol for advanced head and neck cancer. Am J Surg 1994;168:419–22CrossRefGoogle ScholarPubMed
13Robbins, KT, Kumar, P, Regine, WF, Wong, FSH, Weir, AB 3rd, Flick, P et al. Efficacy of targeted superdose cisplatin and concomitant radiation therapy for advanced head and neck cancer: the Memphis experience. Int J Radiat Oncol Biol Phys 1997;38:263–71Google Scholar
14Los, G, Blommaert, FA, Barton, T, Heath, DD, Den Engelse, L, Hanchett, C, Vicario, D, Weisman, R, Robbins, KT, Howell, SB. Selective intra-arterial infusion of high dose cisplatin in advanced head and neck cancer patients results in high tumor platinum concentrations and cisplatin-DNA adduct formation. Can Chemo Pharm 1995;37:150–4CrossRefGoogle ScholarPubMed
15Cheung, DK, Regan, J, Savin, M, Gibberman, V, Woessner, W. A pilot study of intra-arterial chemotherapy with cisplatin in locally advanced head and neck cancers. Cancer 1988;61:903–8Google Scholar
16Lee, YY, Dimery, IW, Van Tassel, P, De Pena, C, Blacklock, JB, Goepfert, H. Superselective intra-arterial chemotherapy of advanced paranasal sinus tumors. Arch Otolaryngol Head Neck Surg 1989;115:503–11CrossRefGoogle ScholarPubMed
17Samant, S, Robbins, T, Vang, M, Wan, J, Robertson, J. Intra-arterial cisplatin and concomitant radiation therapy followed by surgery for advanced paranasal sinus cancer. Arch Otolaryngol Head Neck Surg 2004;130:948–55Google Scholar