Rapid superselective high-dose cisplatin infusion and high-dose rate radiotherapy for advanced tongue cancer

Abstract

Purpose: To evaluate the efficacy of rapid superselective high-dose cisplatin infusion and high-dose-rate radiotherapy for previously untreated patients with advanced tongue cancer.
Patients and Methods: Four patients who rejected radical surgery 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 extrabeam radiotherapy (30-50Gy). And then high-dose-rate radiotherapy and tracheostomy was undergone under general anesthesia. Two patients with persistent neck disease received neck dissection.
Results: One patient is alive without disease 4 years and 4 months after first visit to our hospital. Atrophy of her tongue is seen but she is able to have oral intake the same as before without pain. One patient died with lung metastasis and without loco-regional recurrence eight months after first visit to our hospital. Deep tongue and oral floor ulcer occurred in this patient. The remaining two patients are alive without disease and severe adverse effect although the follow-up periods are short.
Conclusions: We confirmed the efficacy of superselective arterial infusion and high-dose-rate radiotherapy for advanced tongue cancer. Further studies are needed to establish the indications, long-term outcome and possible late adverse effects of this treatment.