Concurrent intra-arterial carboplatin administration and radiation therapy for the treatment of advanced head and neck squamous cell carcinoma: short term results

BACKGROUND: The aim of the present study was to evaluate the survival, efficacy and safety of a modified RADPLAT-like protocol using carboplatin instead of cisplatin. METHODS: Fifty-six patients with primary head and neck squamous cell carcinoma received 4 cycles of intra-arterial carboplatin (350 mg/m2 per cycle every 2 weeks), with concurrent three-dimensional conformal radiation therapy. RESULTS: Two major and 4 minor complications were observed. Forty-five of the 56 patients (80%) completed the protocol, while 11 (20%) patients had to discontinue the intra-arterial infusions due to the occurrence of severe haematological toxicity, but were able to complete radiotherapy. Forty-four (98%) of the 45 patients who completed the protocol and 10 (91%) of the 11 who did not, were free of disease at the end of the treatment, for a comprehensive 96% of CR overall. After a median 23.55 months (range: 2 to 58 months) of follow-up, 40 patients (71%) are alive and disease-free, 1 (2%) is alive but affected by disease and 15 (27%) have died of the disease or other causes. CONCLUSION: Intra-arterial carboplatin administration with concurrent three-dimensional conformal radiation therapy seems to be a promising alternative to RADPLAT in the treatment of advanced head and neck tumours. Haematological and non-haematological toxicities are virtually similar, but carboplatin has the advantage in that it is not nephrotoxic and can be used at very high doses without any significant increase in the extent of side effects

Go-BACK catheter for treatment of iliac artery chronic total occlusion: A case report

The Go-BACK catheter is a novel device designed to be used for both intraluminal crossing or re-entry, into a vessel lumen from the subintimal space during subintimal angioplasty.It is reserved for cases where reentry has not been possible using conventional wire and catheter techniques. We report our experience in recanalization of the chronic total occlusions of the common iliac artery (CIA) using the Go-BACK catheter, in cases where other techniques were unsuccessful

Stent-Graft Repair of Concomitant Occlusion and Anastomotic Pseudoaneurysm in a Prosthetic Femoropopliteal Bypass

Both occlusion and pseudoaneurysm are complications of femoropopliteal bypass surgery. Open revision is the gold standard, but it is associated with high morbidity and mortality compared with endovascular treatment. Percutaneous stent-graft repair is a valid option either for recovering the patency of occluded prosthetic femoropopliteal bypass or for excluding anastomotic pseudoaneurysm. In this report, it is presented a case of occlusion concomitant to a pseudoaneurysm of the distal anastomosis in a previous prosthetic femoropopliteal bypass; a simultaneous endovascular treatment of both complications has been performed through self-expanding stent-graft (Viabahn) placement

Radiochromic films for improved evaluation of patient dose in liver interventions

To investigate a method for evaluation of the maximum skin dose (MSD) of radiation in patients undergoing interventional radiology procedures in the liver. MATERIALS AND METHODS: Transarterial chemoembolization, transarterial embolization, portal vein embolization, and biliary interventions were the procedures considered in this study. Ninety procedures in 70 patients were studied. The complexity of the biliary interventions was taken into account during the analysis. The MSD was measured with use of GAF chromic XR type R films, whereas the dose-area product (DAP) was measured by a transmission chamber. RESULTS: The MSD was measured in a group of 19 patients. The coefficient of the interpolation line between the skin dose and the DAP (0.0051 cm(-2)) was determined. An approximated value of MSD from the DAP for the remaining 71 procedures was estimated by means of an interpolation line. The mean MSD in the endovascular procedures was 4.4 Gy; for the three different levels of complexity of the biliary procedures, the mean MSDs were 0.4, 1.2, and 3 Gy, respectively. CONCLUSIONS: Radiochromic films are an easy-to-use and efficient method for measuring skin entrance radiation dose and have the advantage of providing information on the MSD as well as the distribution of radiation to the skin. In light of these results, the authors suggest recording the dose for biliary and endovascular procedures as indicated by the International Commission on Radiological Protection and the United States Food and Drug Administratio