Rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for hypopharyngeal cancer

Abstract

The survival and functional outcome for hypopharyngeal cancer (HPC) still remains poor despite aggressive standard treatment involving debilitating surgery and postoperative radiation therapy. We reviewed our experience in the management of advanced HPC using rapid superselective high-dose cisplatin infusion with concomitant radiotherapy (RADPLAT) as organ preservation therapy. Twenty-one previously untreated patients with HPC were given superselective intra-arterial infusions of cisplatin (100-120 mg/m²/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and conventional external beam radiotherapy from 2000 through January, 2009. During the median follow-up period of 43 months, the 5-year overall survival and local control rate were 42.8% and 77.8%, respectively. All patients with N0-1 (n=10) are alive wiyhout disease so far. However, the 5-year overall survival of patients with N2b-3(n=24) were 19%. It is not technically easy and sometimes dangerous to treat patients with HPC by intra-arterial chemotherapy. Recently, we consider that patients with T3-4a and N0-1, and primary tumor limited in one side are good candidate for RADPLAT.