Superselective intra-arterial cisplatin infusion and concomitant radiotherapy for maxillary sinus cancer
Menée sur 54 patients atteints d'un carcinome épidermoïde du sinus maxillaire traité entre 1999 et 2010 (durée médiane de suivi : 6,4 ans), cette étude évalue l'efficacité, du point de vue du taux de survie sans progression et du taux de survie globale à 5 ans, et la toxicité d'une perfusion intra-artérielle de cisplatine associée à une angiographie supersélective des artères par tomographie numérique et à une radiothérapie concomitante
Background : The purpose of this study was to evaluate the efficacy of superselective cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with the squamous cell carcinoma of maxillary sinus (SCC-MS). Methods : Between 1999 and 2010, 54 patients were given superselective intra-arterial infusions of cisplatin (100–120 mg m−2 per week) with simultaneous intra-venous infusions of thiosulfate to neutralise cisplatin toxicity and conventional radiotherapy (65–70 Gy). Results : One patient (1.9%) was diagnosed with T2, 14 (25.9%) with T3, 27 (50%) with T4a, and 12 (22.2%) with T4b disease. Lymph-node involvement was present in 12 patients (22.2%). During the median follow-up period of 6.4 years, the 5-year local progression-free and overall survival rates were 65.8 and 67.9% for all patients, respectively. No patient died as a result of treatment toxicity or experienced a cerebrovascular accident. Osteonecrosis (n=5), brain necrosis (n=1), and ocular/visual problems (n=14) were observed as late adverse reactions. Conclusion : We have shown excellent overall survival and local progression-free rate in SCC-MS patients treated by RADPLAT with acceptable rates of acute and late toxicity. A multi-institutional trial is needed to prove that this strategy is a feasible and effective approach for the treatment of SCC-MS.