Phase I study of weekly docetaxel and cisplatin arterial infusion for recurrent head and neck cancer.

BACKGROUND: We planned a phase I study of weekly arterial infusion of docetaxel and cisplatin via a superficial temporal artery for recurrent head and neck cancer to determine the optimal dose. METHODS: The dose of cisplatin was fixed and the dose of docetaxel was escalated from 8 mg/m(2) , with an increase of 2 mg/m(2) per step, to identify the maximum tolerated dose (MTD). In total, 4 courses of weekly chemotherapy were administered. RESULTS: Twelve patients were recruited to this trial. The MTD of docetaxel was 14 mg/m(2) . At this dose level, dose-limiting toxicity was observed in 2 of 3 patients. One patient experienced grade 3 leukopenia, while the other experienced grade 3 leukopenia. Myelosuppression was the dose-limiting toxicity for this regimen. CONCLUSION: The recommended dose for weekly arterial infusion of docetaxel was identified as 12 mg/m(2) combined with weekly cisplatin at 40 mg/m(2) , with 4 courses of each.

A new method using MRI to delineate areas of head and neck cancer targeted by intra-arterial infusion via a superficial temporal artery.

To determine whether anticancer drugs delivered via arterial infusion can permeate entire tumors using a new MRI flow check method. We infused 20 ml of contrast medium (2 ml of Gd-GDPA plus 18 ml of normal saline) over a period of 10 min using a continuous injection pump, then immediately performed MRI using a 1.5 T unit. Images were obtained in 5-mm-thick continuous sections in two or three planes (axial, coronal, and sagittal) depending on the extent of the tumor, and enhanced fast gradient echo 3 D (EFGRE3D) images with a special inversion at lipids were photographed using a neurovascular array coil. The new MRI flow check method delineated an area of tongue cancer perfused with drugs more accurately than conventional methods.The MRI flow check method provides accurate information about areas of arterial infusion.

Clinical outcome of oropharyngeal carcinoma treated with platinum-based chemoradiotherapy.

To determine the efficacy, feasibility, and toxicity of treated with platinum-based chemoradiotherapy for oropharyngeal carcinoma. A retrospective survey of 91 patients who underwent platinum-based chemotherapy and radiotherapy for oropharyngeal cancer at Aichi Cancer Center Hospital between 1971 and 2003. The radiotherapy dose ranged from 50 to 74Gy (median, 66Gy). Nine patients who had a tumor in the base of the tongue were also treated with arterial infusion chemotherapy. At a median follow-up of 63months (range, 2-190 months), 26 (29%) patients developed recurrence. Five patients (5%) developed distant metastases. The 5-year overall survival was 66%, and the relapse-free survival was 51.6%. The 5-year local control rate was 79%. The 5-year local control rate for each subsite was: anterior wall, 90%; lateral wall, 80%; posterior wall, 67%; and superior wall, 64%. The 5-year overall survival was 85% for stage I-II and 62% for stage III-IV. Two patients developed grade 3 (mandibular bone necrosis) or 4 (laryngeal edema) late toxicities. No acute or late grade 5 toxicities were observed. In this study, platinum-based chemoradiotherapy provided good local control for oropharyngeal carcinoma. Although acute and late toxicities occurred, they were considered tolerable.