ABSTRACT
New approaches to the treatment of head and neck cancer involve delivery of the therapeutic agent by direct injection into the tumor lesions. This locoregional therapy allows adaptation of conventional chemotherapy agents, such as bleomycin and cisplatin, to achieve higher drug concentrations in the tumor while avoiding severe systemic toxicities. Novel therapies administered through tumor injection, such as gene transfer, photosensitization, and biologic response modification, have been investigated in preclinical studies and are currently in different phases of clinical trial.
Subject(s)
Antineoplastic Agents/administration & dosage , Head and Neck Neoplasms/drug therapy , Antibiotics, Antineoplastic/administration & dosage , Antiviral Agents/therapeutic use , Bleomycin/administration & dosage , Cisplatin/administration & dosage , Electroporation , Genetic Therapy , Head and Neck Neoplasms/genetics , Head and Neck Neoplasms/immunology , Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/therapy , Humans , Immunologic Factors/therapeutic use , Immunotherapy, Adoptive , Injections, Intralesional , Interleukin-2/therapeutic use , Laser Therapy , Photosensitizing Agents/therapeutic use , Picibanil/therapeutic useABSTRACT
BACKGROUND: Standard ilioinguinal node dissection for melanoma has substantial cost and morbidity. Beginning in 1988, we modified the procedure in hopes of reducing side effects without compromising survival. PATIENTS AND METHODS: Dissection was standard except for preservation of saphenous vein and femoral sheath and omission of sartorius muscle transfer. To date, 19 patients with recurrent melanoma in the groin have had the procedure, 6 for N1 disease and 13 for N2, M1 metastases. RESULTS: Average hospital stay was 4.5 days (range 3 to 7). Postoperative edema occurred in 1 (5%) patient. Disease-free survival at 40 months was 66% for N1 disease and 26% for N2, M1 metastases. CONCLUSION: Modified ilioinguinal node dissection appears to reduce cost and morbidity of treating recurrent melanoma in the groin without compromising survival.
