Combination of cisplatin and laser thermal therapy for head and neck cancer

Abstract

Laser thermal ablation of malignant tumors using the Nd:YAG laser continues to expand into a multi-discipline specialty known as “laser induced thermal-therapy (LITT)”. This minimally invasive treatment has proved to be very useful, particularly for palliation of advanced obstructing cancers of the gastrointestinal and bronchial tracts by endoscopic recanalization. During LITT high photo-thermal laser energy levels are delivered to the area of maximum obstruction inducing irreversible coagulative changes while lower levels to the tumor margin. Reversible hyperthermic damage in the tumor margins frequently leads to tumor recurrence requiring additional laser application for tumor eradication. In an attempt to improve tumor response after LITT for recurrent head and neck cancer, this investigator has been exploring ways to couple chemotherapy with laser ablation as an adjunct strategy to eliminate regrowth in the periphery of LITT treatment sites. The purpose of this research project is to improve local control of disease in patients with recurrent head and neck cancer, by regional injections of chemotherapy followed by laser therapy. The primary objective of this phase I study is to determine the MTD (maximal toxicity dose) and toxicity of escalating doses of intratumor injections of CDDP combined with a fixed dose of laser thermal therapy using the Nd:YAG laser for patients with refractory head and neck cancer. Secondary objectives is to analyze the impact of combined CDDP-LITT on the quality of life. The quintessencial goal of this minimal invasive treatment is to treat cancer by high doses of intratumor chemotherapy and local hyperthermia. (AU)