Can Epirubicin Be Used in Laryngology Practice Like Mitomycin? An Experimental and Pioneering Study

Epirubicin and mitomycin-C share similar mechanisms of action, with both exhibiting antiproliferative effects by inhibiting DNA and protein synthesis. While the efficacy of mitomycin-C in laryngology is well established, this study aims to investigate whether epirubicin can produce comparable clinical outcomes in this field.

Ten rabbits were included in this experimental study. A thermal injury was created at the posterior commissure using a conchal probe. Following the injury, one group was treated with mitomycin-C, while the other received epirubicin. After a six-week post-treatment period, the rabbits were euthanized, and both macroscopic and microscopic evaluations were performed to assess stenosis, scarring, granulation tissue, necrosis, and ulceration. Two pathologists, blinded to the treatment groups, independently examined the histological samples.

Macroscopically, no significant differences were observed between the two groups in terms of scarring, synechiae, or granulation tissue formation at the posterior commissure. However, the mitomycin-C group demonstrated a relatively milder tissue response. Microscopic analysis revealed grade 3 collagen deposition in one rabbit and grade 1 in two rabbits from the epirubicin group. In comparison, the mitomycin-C group showed grade 1 deposition in two rabbits and grade 2 in another two. The average fibroblast count was 83.3 in the epirubicin group versus 59 in the mitomycin-C group.

Although this pioneering study does not provide conclusive evidence that epirubicin is as effective as or superior to mitomycin-C in laryngology, it highlights epirubicin's potential as a promising candidate for further investigation in the treatment of laryngeal conditions.