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[Intra-arterial cisplatin and sequential radiotherapy. Long-term follow-up]
J V Scheel1, V Schilling, E Kastenbauer
1HNO-Abteilung, Allgemeines Krankenhaus Altona, Hamburg.
Background:
The objective of this study was to improve the results of irradiation by prior application of intraarterial (i.a.) chemotherapy with cisplatin.
Methods:
Sixty-three patients suffering from advanced head and neck cancer without previous treatment were prepared for intraarterial chemotherapy by neck dissection without resection of the primary tumor and by modification of the carotid artery by creating a more inferiorly positioned bifurcation to facilitate intermittent i.a. infusion. The patients received approximately 400 mg cisplatin over a period of four to five weeks followed by irradiation with 60Co (64 Gy HD).
Results:
The survival rate at five years in all patients with adequate i.a. chemotherapy was 19 of 49 (39%), except those with adenoid-cystic carcinoma, who had a five-year-survival rate of 100%.
Conclusion:
The results indicate that inductive i.a. chemotherapy with cisplatin has a positive influence on the outcome of irradiation even in inoperable head and neck cancer, which is defined by a longer period of remission with the possibility of curing the disease.