The effect of intraarterial high-dose cisplatin on lymph nodes in oral and oropharyngeal cancer

Aim of Study: To assess the effect of strictly local treatment [intraarterial chemotherapy (iaCHT) with high-dose cisplatin and parallel neutralization] in the primary oral and oropharyngeal cancer (OOSCC) on the dependent cervical lymph nodes. Patients and Methods: Seventeen consecutive patients with OOSCC and clinically positive necks underwent a prospective blinded comparison of two pre-surgical fluor18-deoxyglucose (FDG)-positron emission tomography (PET) examinations: baseline examination 1 week before and follow-up examination 3 weeks after iaCHT. Maximal standardized uptake (SUVmax) values of lymph nodes were measured and compared with each other and histopathology. Results: The SUVmax value of the primary and all neck lymph nodes with uptake decreased significantly. Twelve/17 patients having metastases revealed significant decrease ( P = 0.03), and benign lymph nodes showed non-significant decrease of the SUVmax. All neck lymph nodes with uptake and nodal metastases showed a significant reduction ( P = 0.004) of standard uptake values (SUV). Conclusion: A regional effect of intraarterial cisplatin is proven. To date, it is not clear whether this is due to decreasing inflammatory reaction or a translymphatic anti-neoplastic effect.