LASER AND CISPLATINUM FOR TREATMENT OF HUMAN SQUAMOUS-CELL CARCINOMA

Objective: Interstitial laser therapy (ILT) with the neodymium:yttrium -aluminum-garnet (Nd:YAG) (1064 nm) laser via fiberoptics is becoming a more precise, minimally invasive alternative for thermoablation of u nresectable or recurrent head and neck neoplasms, but recurrence is of ten seen at the margin. Combining intratumor chemotherapy with interst itial laser should be most effective using drugs activated by thermal energy. The objective of the current study was to test intratumor cisp latinum (cis-di-aminedichloroplatinum [CDDP]) injections given in conj unction with laser therapy as an experimental approach for improved tr eatment of squamous cell carcinoma (SCC), Methods: Human SCC tumors we re grown as subcutaneous transplants in nude mice and injected with CD DP (0.4 to 1.2 mg/g) in water or in collagen-based gel carrier with ep inephrine (epi-gel) followed by ILT via 0.6-mm fiberoptics coupled to an Nd:YAG laser (1064 nm/180 J). Results: Tumors injected with CDDP ep i-gel exhibited a partial response with two- to fourfold tumor delay c ompared with aqueous drug or untreated SCC transplants during 10 weeks ' follow-up, Combined drug and laser therapy significantly (P < .01) d ecreased tumor volume, with recurrence in only 25% of animals tested c ompared with 78% tumor regrowth after ILT alone. Conclusion: These ini tial results suggest that laser chemotherapy may become an effective t reatment for advanced head and neck cancer.