Highly selective infusions of supradose Cisplatin for cranial base malignancies

Limb cooling with targeted arterial infusion of cold fluid alleviates scald injury: an experimental rabbit study

BACKGROUND

To investigate the cooling and healing effect of different modalities: Hydrogel dressing(®) was compared with targeted artery injection of low temperature liquid as a coolant following application to a fresh deep partial thickness hot water scald in a rabbit hind limb model.

MATERIALS AND METHODS

Fifty five rabbits were randomly divided into 5 groups. Treatment group received femoral artery injection of low temperature liquid and hydrogel dressing post burn 30 min or 1 hour. Control group were just scalded. Subcutaneous (Tu) and deep mussel temperatures (Tm) were continually monitored in all wounds. After scald the rectal temperature were detected within 6 hours. The wounds were biopsied for histological assessment at 72 h and 3 weeks.

RESULTS

Effective cooling of the burn wound and an increased rate of wound healing was achieved by both treatment methods. The final temperature at 1h decreased to the preburn temperature. Compared with hydrogel dressing group (Tm decreased by 1.3 ± 0.4°C), Tm decreased by 2.8 ± 0.3°C in femoral artery injection group, showing significant difference (P < 0.05). Artery injection of low temperature liquid and hydrogel dressing almost exert no influence on rabbit core temperature. Clinical and histological assessment at 21 days indicated more rapid healing in both the 30 min hydrogel dressing and artery injection burns compared with the controls and the 60 minutes intervention groups.

CONCLUSION

This result indicates artery injection of low temperature liquid earlier to cooling limb is an effective means to reduce residual heat damage tissue without affect core temperature and increase wound healing.

Targeted infusions of supradose Cisplatin with systemic neutralization for carcinomas invading the temporal bone

In an attempt to improve the dismal prognosis for patients with advanced cancer involving the temporal bone, a regional chemotherapy technique was piloted as part of the multimodality therapy for such patients. Rapid supradose cisplatin infusions selectively delivered to the lesion were given to 14 patients with carcinoma involving the temporal bone. Concurrent systemic cisplatin neutralization was achieved with sodium thiosulfate which permitted the use of cisplatin dose intensity regimens equivalent to fivefold the conventional amount. Four patients received chemotherapy alone, four had concomitant irradiation, and six had subsequent irradiation and/or temporal bone surgery. All patients tolerated the chemotherapy without significant complications or toxicity.All three of the patients with previously untreated disease responded to chemotherapy (2 Crs, 1 PR); three of the seven patients with recurrent disease responded to chemotherapy; and all four patients treated with chemoradiation had a complete response (including one patient with recurrent disease). The median follow-up time was 19 months (range, 5 to 63 months). Nine of the 14 patients are alive, including the 4 who were treated with targeted chemoradiation.The use of targeted high-dose chemotherapy for patients with malignant skull base lesions offers hope for improved outcome, particularly when this regimen is given simultaneously with radiation.