Organ preservation following radiation therapy and concurrent intra‐arterial low dose cisplatin infusion for advanced T2 and T3 laryngeal cancer: Long‐term clinical results from a pilot study

Abstract

Background This pilot study evaluated the long‐term outcomes of patients with advanced T2 or T3 squamous cell carcinoma of the larynx (SCC‐L) who were treated with selective intra‐arterial cisplatin and concomitant radiotherapy (RADPLAT). Methods We retrospectively investigated the data of 49 patients with advanced T2 or T3 SCC‐L who received a RADPLAT regimen with low‐dose cisplatin. Results The 5‐year locoregional control, disease‐specific survival, and overall survival rates were 83.3%, 88.1%, and 82.6%, respectively, while the 5‐year freedom from laryngectomy, laryngectomy‐free survival, and laryngo‐esophageal dysfunction‐free survival rates were 89.6%, 79.4%, and 77.1%, respectively. The incidences of grade 3‐4 hematologic and nonhematologic toxicities were 18% and 6%, respectively. Although two patients (4%) developed late toxicities within 5 years following RADPLAT, no other events were noted beyond 5 years. Conclusion This pilot study demonstrated that RADPLAT is feasible and safe and yielded favorable survival outcomes and functional laryngeal preservation in patients with advanced T2 or T3 SCC‐L. Level of evidence 3

Quality of life following treatment with intra-arterial cisplatin with concurrent radiation and erlotinib for locally advanced head and neck cancer

“…Another caveat to our toxicity findings includes the fact that we used a different delivery method of cisplatin, namely, intra-arterial, with peripheral neutralization. In a study conducted by Ono et al, 3.8% of the patients presented with late toxicities (chondronecrosis and severe dysphagia) within, but not after, 5years following intra-arterial cisplatin with concurrent radiation treatment [ 28 ]. Although we did not observe significantly higher side effects than other studies employing chemoradiation to treat locally advanced head and neck cancers, it is possible that the use of an intra-arterial method of delivery of cisplatin enabled patients to tolerate a biologic therapy better and kept long-term side effects to historical levels.…”

Highly sensitive detection of CYFRA21-1 with a SERS sensing platform based on the MBs enrichment strategy and antibody-DNA-mediated CHA amplification

“…The 5-year relative survival rate for patients with LC varies widely according to tumor site and stage. However, it should be noted that the 5-year survival rate of LC has been proved to decline gradually over the past 40 years, from 66% to 63% since most patients have developed to the middle and late stages by the time they are diagnosed, missing the best treatment period ( Ono et al, 2020 ; Miskiewicz-Orczyk et al, 2021 ; Mur et al, 2022 ; Zhou et al, 2022 ). Therefore, early detection, diagnosis and treatment are crucial to improve the prognosis of LC.…”

Comparative Treatment Outcome in T3N0 Glottic Cancer With and Without Vocal Fold Fixation Receiving Radiation Therapy and Concurrent Low-Dose Intra-Arterial Cisplatin Infusion

“…11,12 At our institution, RADPLAT consists of a lower dose (75 mg/body/week × 4) of cisplatin (modified RADPLAT or m-RADPLAT) than the original dose (150 mg/m 2 / week × 4) reported by Robbins et al 3 and this protocol has been performed for organ and function preservation in patients with locally advanced laryngeal cancer and results showing a lower rate of adverse events have been reported. 13 According to the National Comprehensive Cancer Network guidelines, it is generally recommended to select larynx preservation therapy and total laryngectomy in T1-T2 and T4 glottic laryngeal cancer, respectively. 14 Multiple management options are available for T3 tumors, including larynx preservation and non-preservation therapies by RT, CRT, or induction chemotherapy.…”

“…At our institution, RADPLAT consists of a lower dose (75 mg/body/week × 4) of cisplatin (modified RADPLAT or m-RADPLAT) than the original dose (150 mg/m 2 /week × 4) reported by Robbins et al 3 and this protocol has been performed for organ and function preservation in patients with locally advanced laryngeal cancer and results showing a lower rate of adverse events have been reported. 13…”