New development of superselective arterial infusion for head and neck cancer.

本文于2006年4月至2008年3月对35例未经治疗的晚期头颈癌患者进行顺铂超选择性动脉内输注（100-120 mg/m^2/周），同时静脉滴注硫硫硫酸盐以中和顺铂毒性，同时进行常规束外放疗（RADPLAT）。原发肿瘤部位包括鼻窦和鼻窦（n=12）、下咽（n=8）、口咽（n=6）、喉（n=6）、口腔（n=2）、腮腺（n=1）和外耳道（n=1）。对2006年或之前接受治疗的111名患者进行了分析。中位随访27个月，所有患者的5年总生存率为69%，局部控制率为88%。T4b以下肿瘤患者局部控制率为91%，T4b肿瘤患者局部控制率为74%。然而，T4b肿瘤患者的5年总生存率为49%。T4b肿瘤患者5年总生存率为49%。下咽癌患者的5年总生存率为49%。与其他主要站点相比，情况更糟。我们对下咽癌进行了更详细的分析。T4b和/或N2c-3患者的总生存期和局部控制较差。此外，位于中线的下咽癌患者的局部控制较差。除了临床病理因素外，还分析了生物标志物，以确定它们是否与临床结果相关。不幸的是，生物标志物不能预测总体生存和局部控制。RADPLAT对癌细胞的根除效果良好。因此，它可以克服癌细胞对放疗和化疗的低敏感性。另一个原因可能是病例数量不足。需要进一步的研究来确定这种治疗的预后因素、适应症和长期结果。

Thirty-five patients with untreated and advanced head and neck cancer were given superselective intra-arterial infusions of cisplatin (100-120 mg/m^2/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and conventional extra-beam radiotherapy (RADPLAT) between April 2006 and March 2008. Primary tumor sites included the nasal and paranasal sinuses (n=12), hypopharynx (n=8), oropharynx (n=6), larynx (n=6), oral cavity (n=2), parotidgland (n=1), and external auditory meatus (n=1).One hundred and eleven patients who were treated in or before 2006 were analyzed. During the median follow-up period of 27 months, the 5-year overall survival and local control of all patients were 69% and 88%, respectively. The local control rate of patients with less than T4b tumor was 91%, and those with T4b was 74%. However, the 5-year overall survival of patients T4b tumor was 49%. And the 5-year overall survival of patients T4b tumor was 49%. And the 5-year overall survival of patients with hypopharyngeal cancer was 49%. It was worse compared with other primary sites.We analyzed more in detail in hypopharyngeal cancer. Patients with T4b and/or N2c-3 had poor overall survival and local control. In addition, patients with hypopharyngeal cancer located in the midline had poor local control. In addition to clinicopathological factors, biological markers were analyzed to determine whether they were associated with a clinical outcome. Unfortunately, biological markers were not prognostic for overall survival and local control. RADPLAT eradicated cancer cells and showed excellent result. Therefore, it could overcome the low sensitivity to radiotherapy and chemotherapy of the cancer cells.Another reason may be the insufficient number of cases.Further studies are needed to establish the prognostic factors, the indications, and long-term outcome of this treatment.