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Selective Intra-Arterial Infusion Chemotherapy for Nasal and Paranasal Sinus Tumors
Otolaryngology– Head and Neck Surgery Volume 133 Number 2
P037 Selective Intra-Arterial Infusion Chemotherapy for Nasal and Paranasal Sinus Tumors Yoshimi Miyajima, MD (presenter); Kikuo Sakamoto, MD; Tadashi Nakashima, MD PhD; Naofumi Hayabuchi, MD; Toshi Abe, MD; Norimitsu Tanaka, MD Kurume Japan; Kurume Japan; Kurume Japan; Kurume Japan; Kurume Japan; Kurume Japan
Objectives: In the treatment of malignant nasal and paranasal cancer, we have applied total maxillectomy, and the patient lost an eye and hard palate, and has poor quality of life. In order to acquire a better quality of life, we used selective intra-arterial infusion chemotherapy. Methods: Since 1998, we have treated 26 malignant nasal and paranasal sinus tumor patients with selective intra-arterial infusion chemotherapy. In this study, we report the results of 19 maxillary sinus, three sphenoid sinus, one ethmoid sinus, and three nasal cavity cancer patients. At present, recurrence was observed in only one maxillary sinus. Intra-arterial infusion of cisplatin (100 mg/body) was delivered rapidly to the tumor, and usually repeated four times. Conventional external-beam irradiation (1.5-2 Gy per fraction ⬃30) was also used. Results: Complete response was seen in 12 patients, and partial response was seen in nine of 26 patients. But five of 26 patients did not show any response. Maxillectomy was additionally applied in eight patients and, as a result, local control was achieved in 20 patients. The three- and five-years actual survival rate for all patients was 64.2%. In the patients with sphenoid cancers or in patients with recurrence, the prognosis was poor. Conclusion: These results indicate that intra-arterial infusion therapy is effective against advanced malignant nasal and paranasal sinus tumors.
P038 The Use of Autotransplantation in the Treatment of Thyroid Disease Howard D Krein, MD PhD (presenter); Edmund A Pribitkin, MD; William M Keane, MD; Jay L. Rothstein, PhD Philadelphia PA; Philadelphia PA; Philadelphia PA; Philadelphia PA
Objectives: The medical complications of thyroid dysfunction can lead to serious disorders including cardiovascular disease and obesity. Accordingly, we hypothesize that hypothyroid patients, at early to intermediate stages of disease, can receive improved treatment through autotransplantation using “detoxified” organs. Methods: Our approach involved the selection of the optimal anatomical site in recipient mice. The primary anatomical sites that were examined include the SCM, peritoneal cavity, kidney capsule and skeletal muscle of the leg. Following this selection we determined the amount of donor tissue required for animal survival; and how much lymphoid infiltration was required to irreversibly damage the organ. Results: Using microsurgical approaches we determined the best anatomical location and the minimum amount of thyroid tissue required was about 10% of the original organ based on follicle number. We measured the kinetics of thyroid recovery using TSH monitoring of serum from transplant recipients and identified the necessary amounts of tissue that restored full thyroid function. We continue to define the conditions to store, culture and retransplant “cleaned” organs into donor mice. Conclusion: Using this model we have established methodology to remove inflammatory infiltrates from thyroids prior to transplantation. The capability to manipulate thyroid organs in culture will pave the way for organ-preservation methods and allow ex vivo gene delivery for the treatment of thyroid and non-thyroid diseases. This pre-clinical animal model will provide the basis for designing and implementing new treatment modalities for patients afflicted with chronic incurable thyroid diseases.
P039 The Autofluorescence in the Staging of Head and Neck Cancer Luigi G Barzan, MD (presenter) Pordenone Italy
Objectives: Dysplasia, carcinoma in situ, and invasive cancer may arise synchronously at different sites in the upper aerodigestive tract (UADT). Autofluorescence presumably improves the diagnostic accuracy for early cancer detection in various organ sites including the UADT Methods: An autofluorescence system, based on filtered xenon light-direct imaging technique designed for bronchos-
POSTERS
mended follow-up visits. Fifteen patients went to their recommended cancer surveillance follow-up visits only. Eight patients had not been seen in our clinic for more than 12 months. Results: Patients who participated in the multidisciplinary head and neck cancer support group had higher scores in five of the eight SF-36 scales and three of the four HNQoL scales, compared to patients who chose not to participate. The three largest improvements in QOL score associated with support group participation were seen in social functioning, emotional well-being, and mental health. Conclusion: Participation in a multidisciplinary head and neck cancer support group is associated with a better overall quality of life.
Scientific Posters P209
P037 Selective Intra-Arterial Infusion Chemotherapy for Nasal and Paranasal Sinus Tumors Yoshimi Miyajima, MD (presenter); Kikuo Sakamoto, MD; Tadashi Nakashima, MD PhD; Naofumi Hayabuchi, MD; Toshi Abe, MD; Norimitsu Tanaka, MD Kurume Japan; Kurume Japan; Kurume Japan; Kurume Japan; Kurume Japan; Kurume Japan
Objectives: In the treatment of malignant nasal and paranasal cancer, we have applied total maxillectomy, and the patient lost an eye and hard palate, and has poor quality of life. In order to acquire a better quality of life, we used selective intra-arterial infusion chemotherapy. Methods: Since 1998, we have treated 26 malignant nasal and paranasal sinus tumor patients with selective intra-arterial infusion chemotherapy. In this study, we report the results of 19 maxillary sinus, three sphenoid sinus, one ethmoid sinus, and three nasal cavity cancer patients. At present, recurrence was observed in only one maxillary sinus. Intra-arterial infusion of cisplatin (100 mg/body) was delivered rapidly to the tumor, and usually repeated four times. Conventional external-beam irradiation (1.5-2 Gy per fraction ⬃30) was also used. Results: Complete response was seen in 12 patients, and partial response was seen in nine of 26 patients. But five of 26 patients did not show any response. Maxillectomy was additionally applied in eight patients and, as a result, local control was achieved in 20 patients. The three- and five-years actual survival rate for all patients was 64.2%. In the patients with sphenoid cancers or in patients with recurrence, the prognosis was poor. Conclusion: These results indicate that intra-arterial infusion therapy is effective against advanced malignant nasal and paranasal sinus tumors.
P038 The Use of Autotransplantation in the Treatment of Thyroid Disease Howard D Krein, MD PhD (presenter); Edmund A Pribitkin, MD; William M Keane, MD; Jay L. Rothstein, PhD Philadelphia PA; Philadelphia PA; Philadelphia PA; Philadelphia PA
Objectives: The medical complications of thyroid dysfunction can lead to serious disorders including cardiovascular disease and obesity. Accordingly, we hypothesize that hypothyroid patients, at early to intermediate stages of disease, can receive improved treatment through autotransplantation using “detoxified” organs. Methods: Our approach involved the selection of the optimal anatomical site in recipient mice. The primary anatomical sites that were examined include the SCM, peritoneal cavity, kidney capsule and skeletal muscle of the leg. Following this selection we determined the amount of donor tissue required for animal survival; and how much lymphoid infiltration was required to irreversibly damage the organ. Results: Using microsurgical approaches we determined the best anatomical location and the minimum amount of thyroid tissue required was about 10% of the original organ based on follicle number. We measured the kinetics of thyroid recovery using TSH monitoring of serum from transplant recipients and identified the necessary amounts of tissue that restored full thyroid function. We continue to define the conditions to store, culture and retransplant “cleaned” organs into donor mice. Conclusion: Using this model we have established methodology to remove inflammatory infiltrates from thyroids prior to transplantation. The capability to manipulate thyroid organs in culture will pave the way for organ-preservation methods and allow ex vivo gene delivery for the treatment of thyroid and non-thyroid diseases. This pre-clinical animal model will provide the basis for designing and implementing new treatment modalities for patients afflicted with chronic incurable thyroid diseases.
P039 The Autofluorescence in the Staging of Head and Neck Cancer Luigi G Barzan, MD (presenter) Pordenone Italy
Objectives: Dysplasia, carcinoma in situ, and invasive cancer may arise synchronously at different sites in the upper aerodigestive tract (UADT). Autofluorescence presumably improves the diagnostic accuracy for early cancer detection in various organ sites including the UADT Methods: An autofluorescence system, based on filtered xenon light-direct imaging technique designed for bronchos-
POSTERS
mended follow-up visits. Fifteen patients went to their recommended cancer surveillance follow-up visits only. Eight patients had not been seen in our clinic for more than 12 months. Results: Patients who participated in the multidisciplinary head and neck cancer support group had higher scores in five of the eight SF-36 scales and three of the four HNQoL scales, compared to patients who chose not to participate. The three largest improvements in QOL score associated with support group participation were seen in social functioning, emotional well-being, and mental health. Conclusion: Participation in a multidisciplinary head and neck cancer support group is associated with a better overall quality of life.
Scientific Posters P209