Neoadjuvant intra-arterial chemotherapy in advanced laryngeal and hypopharyngeal cancer

To investigate whether neoadjuvant intra-arterial chemotherapy down-stages the tumors and predicts ultimate outcome in patients with advanced laryngeal and hypopharyngeal cancer.

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.

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.

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.