Article exists only in Russian.

Article exists only in Russian.

Abstract:

Since December 2010 till September 2012, 24 patients with III stage laryngeal carcinoma (T3_4NxxM0) underwent chemoradiation therapy Intra-arterial chemotherapy via both superior thyroid and laryngeal arteries with intermitting in 30-45 minutes infusions of cisplatin and 5-fluorouracil was done. Average doses of cisplatin consist 75mg/m2, and 5-fluorouracil dose was1000mg/m2. In 48 hours multifractional radiotherapy started (1,1Gy x 2 per day, 5 days per week) with planned total dose 74-78Gy Then total dose was 26-30Gy and 50Gy pauses for 2 or 3 days in radiotherapy established for repeated same intra-arterial chemotherapy In 21 patients (87,5%) total regress of the tumor was marked. In 3 patients (12,5%) sclerosis of residual volume developed without tumor cells in control biopsies. In the only patient (4,2%) after 6 months reoccurrence was marked and dissection laryngectomy managed. Stability of positive results we observe during 12 months following such chemoradiation therapy.

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Abstract:

Aim: was to proceed comparative analysis of immediate and long-term results of chemoradiation treatment of unresectable local-spread oropharyngeal cancer with use of standart chemoradiatior therapy with intravenous chemoinjection and individual volume-controlled superselective intraarterial chemotherapy.

Materials and methods: 43 patients with unresectable oropharyngeal cancer were included in trial comparing intra-arterial (IA) and intravenous (IV) chemoradiation. IV chemoradiation (n=19 patients) comprised 3-4 times of 100 mg/m2 cisplatin infusion on days 1, 22, 43 combined 2Gy x 5 days fractions with total radiation dose 72Gy The IA chemoradiation group (n=24) comprised 3 or 4 x 90 mg/m2 cisplatin administered in the tumor-feeding artery by personified volume- controlled targeted perfusion. The induction IA chemotherapy was given one day before radiation. Then IA chemotherapy conducted regularly 22, 43, 64 days followed radiation.

Results: we made 86 IA procedures and had no IA-related death or procedure related complications. Five patients of IA group were excluded from long term analysis because of non-comleted protocol. The median follow-up was 21±2.3 months in IA group and 36 months in all patients in IV therapy group. In 19 patients received IA chemoradiotherapy protocol - 100% complete response (CR) and in IV chemoradiotherapy - only in 10 (53%) of 19 patients (ф = 6,820, р<0.05). CR was noted in 8 patients with N1 lymph-nodes and in 9 of 10 patients with N2 lymph nodes in IA therapy group. Initial lymph nodes regress more than 80-90% was observed and follow up improvement was confirmed by PET-CT. One-year overall survival (OS) rates were 95% and 79%, respectively in IA and IV groups (not significant OR = 4,8; ф = 1,51; р = 0,05), but two year OS rates were 90% and 58%, respectively (р<0,05). These data are encourage but further follow-up results need to be investigated. 

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