Superselective high‐dose cisplatin infusion with concomitant radiotherapy in patients with advanced cancer of the nasal cavity and paranasal sinuses

Abstract

BACKGROUND: The current study aimed to evaluate the efficacy of superselective high‐dose cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with advanced cancer of the nasal cavity and paranasal sinuses. METHODS: Between October 1999 and December 2006, 47 patients were given superselective intra‐arterial infusions of cisplatin (100‐120 mg/m2 per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional external‐beam radiotherapy (65‐70 grays). RESULTS: There were 7 patients (14.9%) diagnosed with T3, 22 (46.8%) with T4a, and 18 (38.3%) with T4b disease. During the median follow‐up period of 4.6 years, the 5‐year local progression‐free survival rate was 78.4% for all patients (n = 47), 69.0% for patients with T4b disease (n = 18), and 83.2% for patients with <T4b disease (n = 29). The 5‐year overall survival rate was 69.3% for all patients, 61.1% for patients with T4b disease, and 71.1% for patients with < T4b disease. RADPLAT was feasible in 45 patients (95.7%). No patient died as a result of treatment toxicity or had a cerebrovascular accident. Osteonecrosis (n = 7), brain necrosis (n = 2), and ocular/visual problems (n = 16) were observed as late adverse reactions. CONCLUSIONS: Although a single institution experience, the results of the current study suggest that RADPLAT can cure the majority of patients with advanced cancer of the nasal cavity and paranasal sinuses, as well as preserve organs. Late adverse reactions should be monitored in future studies. Cancer 2009. © 2009 American Cancer Society.

Salvage operations for patients with persistent or recurrent cancer of the maxillary sinus after superselective intra-arterial infusion of cisplatin with concurrent radiotherapy

“…In particular, we think that the unresectable tumors or the tumors with orbital invasion may be a good indication for RADPLAT. In Japan, RADPLAT has been reported to be both safe and effective for patients with maxillary sinus cancer [7,8].…”

“…The complication rate of salvage surgery after intensive chemoradiation therapy for patients with head and neck cancer was reported to be 11%-63.2% [7][8][9][10].…”

“…Therefore, multi-modality treatments have been introduced to avoid cosmetic problems as well as to preserve ocular function and to improve patient outcomes. In Japan, superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) has been introduced to preserve the orbital contents and ocular function in patients with advanced maxillary sinus cancer [7,8]. This non-surgical treatment has been reported to be both safe and highly effective.…”

Rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for squamous cell carcinoma of the nasal vestibule: a report of two cases

“…Subsequent advances in vascular radiology techniques have enabled superselective arterial infusion to head and neck structures, and a specific concomitant chemotherapy protocol for head and neck cancer that employs the pharmacologic principles of intra-arterial infusion of cisplatin, while capitalizing on the cisplatin-neutralizing agent sodium thiosulfate, has shown promising results [6,7].…”

Evaluation of nodal response after intra-arterial chemoradiation for node-positive head and neck cancer

“…RADPLAT efficacy of primary sites is high, and RADPLAT followed by planned ND is highly effective for controlling regional disease [5,6].…”