In recent years endoscopically controlled laser-induced thermal therapy (LITT) has been increasingly accepted as a minimally invasive method for palliation of advanced or recurrent head and neck or gastrointestinal cancer. Previous studies have shown that adjuvant chemotherapy can potentiate endoscopic laser thermal ablation of obstructing tumors leading to improved palliation in advanced cancer patients. Eight patients with recurrent head and neck tumors volunteered to enroll as part of an ongoing phase II LITT clinical trial, and also elected to be treated with systemic chemotherapy (cisplatin, 80 mg/m2) followed 24 h later by palliative laser thermal ablation. Laser treatments were repeated in patients with residual disease or recurrence for a total of 27 LITT sessions. Four of the 8 patients treated with laser thermal chemotherapy remained alive after a median follow-up of 12 months. Of the 12 tumor sites treated, complete responses were located in the oral cavity (3), oropharynx (1), hypopharynx (1), maxillary sinus (1), and median survival for these patients was 9.5 months. This initial experience with cisplatinum-based laser chemotherapy indicates both safety and therapeutic potential for palliation of advanced head and neck cancer but this must be confirmed by longer follow-up in a larger cohort of patients.
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机译:近年来,内窥镜控制的激光诱导热疗法(LITT)已被逐渐接受为缓解晚期或复发性头颈部或胃肠道癌的微创方法。先前的研究表明,辅助化疗可增强内镜对阻塞性肿瘤的激光热消融,从而改善晚期癌症患者的缓解症状。 8例复发性头颈部肿瘤患者自愿参加了正在进行的LITT II期临床试验,并选择接受全身化疗(顺铂80 mg / m 2 sup>)治疗,随后进行了24小时后来通过姑息激光热消融术。在残留疾病或复发患者中重复进行激光治疗,共进行27次LITT疗程。中位随访12个月后,接受激光热化学疗法治疗的8例患者中有4例仍然存活。在治疗的12个肿瘤部位中,完全缓解的部位位于口腔(3),口咽(1),下咽(1),上颌窦(1),这些患者的中位生存期为9.5个月。这种基于顺铂的激光化疗的初步经验表明,对晚期头颈癌的缓解具有安全性和治疗潜力,但这必须通过对更大范围的患者进行更长的随访来证实。
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