Rapid superselective high-dose cisplatin infusion for advanced head and neck malignancies

Head Neck. Sep-Oct 1992;14(5):364-71. doi: 10.1002/hed.2880140505.

Abstract

Advances in vascular radiology techniques for superselective arterial infusions and methods to overcome systemic toxicity from high-dose cisplatin chemotherapy encouraged us to reevaluate the effects of rapid regional cisplatin infusion for patients with head and neck malignancies. Twenty patients (17 carcinomas, three sarcomas) received high-dose cisplatin (100-200 mg/m2) by this method. Fifteen of the 17 patients with upper aerodigestive tract carcinoma are part of an ongoing phase I dose escalation of cisplatin with sodium thiosulfate neutralization. Three additional patients with sarcomas were treated with intra-arterial (IA) cisplatin and systemic Adriamycin. Fifty-three IA infusions were performed without any complications. Only minimal toxicity related to the chemotherapy was observed. The overall response rate for previously untreated patients was nine of 10 (90%) [complete response (CR) 67%; partial response (PR) 33%]. The response rate for patients with recurrent disease was five of eight (63%) (CR 20%, PR 80%). The average length of follow-up is 9.5 months and the actuarial survival rate is 56%. Superselective rapid infusion of high-dose cisplatin for patients with advanced head and neck malignancies is feasible, relatively nontoxic, and may have important applications in multimodality therapy, particularly for patients with bulky primary disease.

MeSH terms

  • Antidotes / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma / drug therapy*
  • Carcinoma / mortality
  • Carcinoma / radiotherapy
  • Carcinoma / surgery
  • Cisplatin / administration & dosage*
  • Cisplatin / adverse effects
  • Cisplatin / therapeutic use
  • Combined Modality Therapy
  • Dose-Response Relationship, Drug
  • Doxorubicin / administration & dosage
  • Feasibility Studies
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery
  • Humans
  • Infusions, Intra-Arterial / methods
  • Sarcoma / drug therapy*
  • Sarcoma / mortality
  • Survival Rate
  • Thiosulfates / administration & dosage

Substances

  • Antidotes
  • Thiosulfates
  • Doxorubicin
  • sodium thiosulfate
  • Cisplatin