Intratumor Cisplatin Nephrotoxicity in Combined Laser-Induced Thermal Therapy for Cancer Treatment

Intratumor Cisplatin Nephrotoxicity in Combined Laser-Induced Thermal Therapy for Cancer Treatment

Author Palumbo, Marcel N. Autor UNIFESP Google Scholar
Cervantes, Onivaldo Autor UNIFESP Google Scholar
Eugenio, Cecilia Autor UNIFESP Google Scholar
Hortense, Flavia T. P. Autor UNIFESP Google Scholar
Ribeiro, Joao C. Autor UNIFESP Google Scholar
Paolini, Ana Amelia P. Google Scholar
Tedesco, Antonio C. Google Scholar
Sercarz, Joel A. Google Scholar
Paiva, Marcos B. Autor UNIFESP Google Scholar
Abstract Introduction: Thermal ablation of tumors by Nd:YAG laser has been growing as a multidisciplinary subspecialty defined as laser-induced thermal therapy (LITT), and has been increasingly accepted as a minimally invasive method for palliation of advanced or recurrent cancer. Previous studies have shown that adjuvant chemotherapy can potentiate laser thermal ablation of tumors leading to improved palliation in advanced cancer patients. Objective: Evaluate nephrotoxicity by early markers of renal function in treating head and neck cancer using intra-tumor injections of cisplatin combined with laser-induced thermal therapy CDDP-LITT). Methods: Nine patients with recurrent head and neck tumors were treated by CDDP-LITT in order to determine nephrotoxicity related to this synergistic association. Among the tests requested to detect early were creatinine, magnesium, creatinine clearance, serum urea-BUN, type I urine, and proteinuria at 24 hours. Results: Twelve recurrent tumors in nine patients were treated by CDDP-LITT. Pain was the major complaint four patients), while other symptoms included dysphagia, dyspnea, bleeding, and difficulties in chewing. Fifteen laser procedures were performed and maximal CDDP dose was 50mg. None of the markers for nephrotoxicity showed changes at these levels of CDDP intra-tumor injections. Conclusion: This initial experience with (CDDP-LITT) indicates both safety and therapeutic potential for palliation of advanced head and neck cancer. However, safety and feasibility must be confirmed by longer follow up and further escalation of CDDP doses in a Phase I study to determine maximum tolerated dose (MTD) and demonstrate tangible benefits for patients. (C) 2017 Wiley Periodicals, Inc.
Keywords cisplatin
laser-induced thermal therapy
recurrent/advanced head and neck cancer
Nd:YAG laser
nephrotoxicity
xmlui.dri2xhtml.METS-1.0.item-coverage Hoboken
Language English
Sponsor Department of Head and Neck Surgery, the Jonsson Comprehensive Cancer Center
David Geffen School of Medicine at UCLA
National Institute of Health, National Cancer Institute
Office of Extramural Research, National Institutes of Health
Sao Paulo Research Foundation (FAPESP)
Grant number FAPESP: 08-54714
Date 2017
Published in Lasers In Surgery And Medicine. Hoboken, v. 49, n. 8, p. 756-762, 2017.
ISSN 0196-8092 (Sherpa/Romeo, impact factor)
Publisher Wiley
Extent 756-762
Origin http://dx.doi.org/10.1002/lsm.22685
Access rights Closed access
Type Article
Web of Science ID WOS:000411028000004
URI https://repositorio.unifesp.br/handle/11600/57325

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