Intra-arterial cisplatin with concomitant radiation for advanced hypopharyngeal cancer†‡

Objectives/Hypothesis: The current study evaluated the efficacy of radiation and concomitant high-dose superselective intra-arterial cisplatin infusion (RADPLAT) for patients with advanced hypopharyngeal cancer. Study Design: Retrospective, single-institutional study. Methods: Between February 2004 and October 2010, 43 patients with T2N0 or worse cancer were given superselective intra-arterial infusions of cisplatin (100-mg/m2 or 75-mg flat dose per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional external beam radiotherapy (60–66 Gy). Results: In total, three, seven, 21, and 12 patients were diagnosed with stage II, III, IVA, and IVB cancer, respectively. During the median follow-up period of 34 months, the 3-year overall survival, disease-specific survival, and progression-free survival rates for all patients were 52.2%, 68.2%, and 56.1%, respectively. The 3-year local control and laryngoesophageal dysfunction-free survival rates were 81.6% and 49.4%, respectively. No patient died because of treatment toxicity. Among grade IV toxicity, cerebral infarction (n = 1) and laryngeal necrosis (n = 1) resulting in laryngectomy were observed. Conclusions: Despite being a single-institution experience, the results of the current study suggest that RADPLAT can achieve favorable survival rates and high rates of laryngeal preservation for patients with advanced hypopharyngeal cancers. Laryngoscope, 2012