[Intra-arterial cisplatin and sequential radiotherapy. Long-term follow-up]. / Cisplatin intraarteriell und sequentielle Strahlentherapie. Langzeit-Ergebnisse.

BACKGROUND: The objective of this study was to improve the results of irradiation by prior application of intraarterial (i.a.) chemotherapy with cisplatin. METHODS: Sixty-three patients suffering from advanced head and neck cancer without previous treatment were prepared for intraarterial chemotherapy by neck dissection without resection of the primary tumor and by modification of the carotid artery by creating a more inferiorly positioned bifurcation to facilitate intermittent i.a. infusion. The patients received approximately 400 mg cisplatin over a period of four to five weeks followed by irradiation with 60Co (64 Gy HD). RESULTS: The survival rate at five years in all patients with adequate i.a. chemotherapy was 19 of 49 (39%), except those with adenoid-cystic carcinoma, who had a five-year-survival rate of 100%. CONCLUSION: The results indicate that inductive i.a. chemotherapy with cisplatin has a positive influence on the outcome of irradiation even in inoperable head and neck cancer, which is defined by a longer period of remission with the possibility of curing the disease.

[Damage to inner ear function caused by the effect of ionizing rays]. / Beeinträchtigung der Innenohrfunktion durch die Einwirkung ionisierender Strahlen.

In the literature the inner ear is claimed to be resistent to the effects of ionizing irradiation. We therefore studied the inner ear function in a group of 49 patients who had undergone radiotherapy for malignant tumors of the head in which the irradiated field included at least one inner ear. 67 ears had been irradiated, 46 of them showed a sensorineural hearing loss of 10 dB or more. The frequency and the degree of the inner ear damage was correlated with the dosage of the irradiation and with the time elapsed after the end of radiotherapy.