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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
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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

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