Combined modality treatment of oral and oropharyngeal cancer including neoadjuvant intraarterial cisplatin and radical surgery followed by concurrent radiation and chemotherapy with weekly docebaxel – three year results of a pilot study

Multimodality Treatment Including Postoperative Radiation and Concurrent Chemotherapy with Weekly Docetaxel is Feasible and Effective in Patients with Oral and Oropharyngeal Cancer

“…Therefore we considered a combination of several locally active treatment modalities a reasonable and promising approach. Published data suggest that intra-arterial high-dose chemotherapy is associated with a very low incidence of acute systemic side effects [22][23][24]; this is particularly important for the treatment of patients with a high comorbidity. Our results confirm that high-dose intra-arterial cisplatin is feasible, well tolerated and highly effective.…”

Audiometric Patterns in Ototoxicity of Intra-Arterial Cisplatin Chemoradiation in Patients with Locally Advanced Head and Neck Cancer

“…Although ototoxicity is known to be a major side effect of (high-dose) cisplatin and of RT [Evans et al, 1981;Kopelman et al, 1988;Fleming et al, 1985;Myers et al, 1991;Laurell and Jungnelius, 1990;Raaijmakers and Engelen, 2002;Johannesen et al, 2002], previous reports describing outcome of clinical trials with RADPLAT do not comment on the incidence and extent of hearing loss due to treatment [Michael et al, 2005;Regine et al, 2000; Audiometric Patterns in Cisplatin Chemoradiation Ototoxicity Audiol Neurotol 2006;11:318-330 319 Kovács et al, 2002]. Nevertheless, significant hearing loss due to RADPLAT was shown in studies of Madasu et al [1997] and Balm et al [2004].…”

Relevance of positive margins in case of adjuvant therapy of oral cancer

“…Intraarterial chemotherapy has been administered to every patient irrespective of stage. First results have been reported elsewhere 8,9 . The age and clinical stage distribution was very similar to an unselected population ( Table 2).…”

“…Post-operative radiotherapy became accepted because studies suggested a lower recurrence rate even after unsatisfactory surgical margins 25 . We nevertheless introduced different adjuvant strategies (polychemotherapy, chemoradiation 7,8 ) with the aim to increase the altogether poor survival rates of oral and oropharyngeal cancer patients. It may be interesting to investigate the role of positive margins in the context of these adjuvant strategies.…”