Platinum concentration in sentinel lymph nodes after preoperative intra-arterial cisplatin chemotherapy targeting primary tongue cancer

Abstract

Conclusion.We concluded that intra-arterially injected cisplatin passed via lymph flow into sentinel nodes (SNs) as the platinum concentration in the SNs was higher than that in the non-sentinel nodes (NSNs). It is possible that pre-operative intra-arterial chemotherapy targeting primary cancer also has a therapeutic effect on subclinical metastatic SNs.Objectives. Intra-arterial chemoradiotherapy has been reported to be effective against not only primary tumors but also nodal metastases. We considered the hypothesis that intra-arterially injected cisplatin passed via lymph flow into regional nodes. This study aimed to investigate intra-arterially injected cisplatin distribution to regional nodes by comparing platinum concentrations in SNs and NSNs.Method. Five patients with T1-2 N0 tongue cancer were treated with preoperative intra-arterial chemotherapy (cisplatin, 100mg/m 2 ) targeting primary cancer. Partial glossectomy together with SN biopsy and elective neck dissection were performed two weeks after intra-arterial chemotherapy. Platinum concentrations in the lymph nodes were measured using a Zeeman atomic absorption spectrometer.Results. Thirteen SNs were harvested together with 8 NSNs from the adjacent areas to the SNs. Platinum concentrations were then measured, revealing a significant difference in platinum concentration between the SNs and the NSNs (mean±SD, 0.682±0.246 µg/g vs 0.506±0.274 µg/g; p=0.049).

The incidence of late neck recurrence in N0 maxillary sinus squamous cell carcinomas after superselective intra-arterial chemoradiotherapy without prophylactic neck irradiation

“…The reason for the low recurrence rate in our study is speculated to be that intra-arterially injected cisplatin targeting the primary tumor has a beneficial effect on subclinical metastatic lymph nodes. It has been reported that intra-arterially injected cisplatin can pass, via lymph flow, into the lymph nodes in patients with tongue cancer [8][9]. These reports appear to support our hypothesis.…”

Clinical and histopathologic effects of neoadjuvant intra-arterial chemoradiotherapy with cisplatin in combination with oral S-1 on stage III and IV oral cancer

“…20 Some reports have also suggested that superselective IACRT has a beneficial effect on cervical lymph node metastasis 10,21 and achieves significantly higher platinum levels in sentinel lymph nodes when the IACRT is cisplatin-based. 22 The markedly favorable histologic response seen in the authors' study likely reflects the synergistic effect of cisplatin-based intra-arterial chemotherapy spreading from the primary lesion to cervical lymph node metastases and the combination of RT with S-1. The effect on OSCC was detectable after only 1 or 2 infusions of intra-arterial chemotherapy combined with the minimum dose of RT (40 Gy).…”