Combined Cisplatinum and Laser Thermal Therapy for Palliation of Recurrent Head and Neck Tumors

摘要

In recent years endoscopically controlled laser-induced thermal therapy (LITT) has beenincreasingly accepted as a minimally invasive method for palliation of advanced or recurrenthead and neck or gastrointestinal cancer. Previous studies have shown that adjuvantchemotherapy can potentiate endoscopic laser thermal ablation of obstructing tumors leadingto improved palliation in advanced cancer patients. Eight patients with recurrent head andneck tumors volunteered to enroll as part of an ongoing phase II LITT clinical trial, and alsoelected to be treated with systemic chemotherapy (cisplatin, 80 mg/m2) followed 24 h later bypalliative laser thermal ablation. Laser treatments were repeated in patients with residualdisease or recurrence for a total of 27 LITT sessions. Four of the 8 patients treated with laserthermal chemotherapy remained alive after a median follow-up of 12 months. Of the 12 tumorsites 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 andtherapeutic potential for palliation of advanced head and neck cancer but this must be confirmedby longer follow-up in a larger cohort of patients.