Hemodialysis patients often have various underlying diseases that hinder radical treatment for cancer. We herein report a hemodialysis patient with advanced hypopharyngeal carcinoma who was successfully treated by concurrent chemoradiotherapy (CCRT).
A 75-year-old man was presented with a one-month history of bilateral cervical swelling and pharyngeal pain. He had been receiving hemodialysis for 10 years, and had a number of underlying diseases including diabetes mellitus, hypertension, angina pectoris, and depression. From the findings of endoscopic, imaging and histopathological examinations, he was diagnosed as a hypopharyngeal carcinoma (pyriform sinus, T2N2cM0). Upon the patient's request for laryngeal preservation, we performed bilateral neck dissection followed by CCRT with cisplatin. Cisplatin was intravenously administered at a dose of 10 mg/body on the days of hemodialysis (3 times/week). Hemodialysis was started 30 minutes after the completion of cisplatin infusion. Total and free cisplatin concentrations in the blood were measured just before and after hemodialysis on each day. CCRT was completed without severe adverse events except grade 3 anemia and thrombopenia, and complete remission of the disease was achieved. The total cisplatin concentration remained within a safety limit (< 1.0 μg/ml) throughout the course.
We emphasize that CCRT with cisplatin can be conducted safely and successfully even in hemodialysis patients by monitoring cisplatin concentration.