Phase I study to assess the safety of hyperthermic intracavitary chemotherapy in advanced oral cavity cancer

Head and neck cancer is the third most common cancer in the Indian subcontinent with oral cavity subsite being the most affected.A large number of cases report at an advanced stage (Stage III and IV). These advanced cancer patients have a higher incidence of disease returning early, even after completing the currently prescribed treatment. This has found to affect longevity and quality of life. Various treatments have been researched in an effort to prolong life in these advanced cancer patients. Moreover, with the presence of certain disease characteristics like tumours spreading into its surroundings, can affect the chances of the disease coming back again very soon. To overcome this, treatments such as chemotherapy before surgery have shown promise but can only be given up to a limited dosage via intravenous route to avoid drastic side effects. Despite this, the longevity after treatment is poor and a lot of unanswered questions remain in the treatment of these advanced cases. These issues are also present in cancers of other sites. To tackle these issues clinicians dealing with abdomen, chest and bladder cancers, a treatment involving using circulated, heated chemotherapy in the cavity has shown promising results. This is a kind of “wash” given into the cavity so that tumour cells are killed locally without any systemic side effects. In this way, the chemotherapy can be used in higher doses at the site of the cancer, without the side effects noted in the intravenous route. While this is standard practice for cancers in other places, it has not been tried in the head and neck. This study is a pilot of 12 individuals that will assess the safety and help determine a safe dose of using this method for oral cavity cancers.