Can Epirubicin Be Used in Laryngology Practice Like Mitomycin? An Experimental and Pioneering Study

Document Type : Original

Authors

1 University of Health Sciences Kocaeli Derince Health Research and Application Center, Otorhinolaryngology and Head & Neck Surgery Clinic.

2 University of Health Sciences Kocaeli Derince Health Research and Application Center, Otorhinolaryngology and Head & Neck Surgery Clinic.

3 Kocaeli University Faculty of Medicine, Pathology Clinic.

10.22038/ijorl.2025.87024.3938

Abstract

Introduction:
Epirubicin and mitomycin-C share similar mechanisms of action, with both exhibiting antiproliferative effects by inhibiting DNA and protein synthesis. While the efficacy of mitomycin-C in laryngology is well established, this study aims to investigate whether epirubicin can produce comparable clinical outcomes in this field.
 Materials and Methods:
Ten rabbits were included in this experimental study. A thermal injury was created at the posterior commissure using a conchal probe. Following the injury, one group was treated with mitomycin-C, while the other received epirubicin. After a six-week post-treatment period, the rabbits were euthanized, and both macroscopic and microscopic evaluations were performed to assess stenosis, scarring, granulation tissue, necrosis, and ulceration. Two pathologists, blinded to the treatment groups, independently examined the histological samples.
Results:
Macroscopically, no significant differences were observed between the two groups in terms of scarring, synechiae, or granulation tissue formation at the posterior commissure. However, the mitomycin-C group demonstrated a relatively milder tissue response. Microscopic analysis revealed grade 3 collagen deposition in one rabbit and grade 1 in two rabbits from the epirubicin group. In comparison, the mitomycin-C group showed grade 1 deposition in two rabbits and grade 2 in another two. The average fibroblast count was 83.3 in the epirubicin group versus 59 in the mitomycin-C group.
Conclusions:
Although this pioneering study does not provide conclusive evidence that epirubicin is as effective as or superior to mitomycin-C in laryngology, it highlights epirubicin’s potential as a promising candidate for further investigation in the treatment of laryngeal conditions.

Keywords

Main Subjects

References

  1. Carpenter DJ, Hamdi OA, Finberg AM, Daniero JJ. Laryngotracheal stenosis: Mechanistic review. Head Neck 2022; 44:1948–60. https:// doi.org/10. 1002/hed.27079.
  2. Smith MM, Cotton RT. Diagnosis and management of laryngotracheal stenosis. Expert Rev Respir Med 2018; 12:709–17. https:// doi. org/10. 1080/17476348.2018.1495564.
  3. Di Felice C, Machuzak MS, Shepherd RW. Use of Mitomycin-C in Laryngotracheal Stenosis: A Focused Clinical Review. J Bronchology Interv Pulmonol 2023; 30:223–31. https: //doi. org/10. 1097/LBR.0000000000000933.
  4. Queiroga TLO, Cataneo DC, Martins RHG, Reis TA, Cataneo AJM. Mitomycin C in the Endoscopic Treatment of Laryngotracheal Stenosis: Systematic Review and Proportional Meta-Analysis. Int Arch Otorhinolaryngol 2020;24:e112–24. https:// doi. org/10. 1055/s-0039-1700582.
  5. Luu K, Tellez PA, Chadha NK. The effectiveness of mitomycin C in Otolaryngology procedures: A systematic review. Clin Otolaryngol 2022; 47:1–13. https://doi.org/10.1111/coa.13839.
  6. Görgülü O, Ozdemir S, Görgülü FF, Altin A, Selçuk T, Akbaş Y. Adjunctive use of mitomycin C in endoscopic revision dacryocystorhinostomy. B-ENT 2012; 8:123–6.
  7. Aldriweesh B, Alshareef W, Alsini A, Aljasser A, Alammar A. Safety profile and efficacy of high-dose topical mitomycin-C for choanal atresia repair: A prospective cohort study. Int J Pediatr Otorhinolaryngol 2022; 159:111190. https:// doi. org/10. 1016/j.ijporl.2022.111190.
  8. Uhlen S, Fayoux P, Vachin F, Guimber D, Gottrand F, Turck D, et al. Mitomycin C: an alternative conservative treatment for refractory esophageal stricture in children? Endoscopy 2006; 38:404–7. https://doi.org/10.1055/s-2006-925054.
  9. Luiz MT, Dutra JAP, Di Filippo LD, Junior AGT, Tofani LB, Marchetti JM, et al. Epirubicin: Biological Properties, Analytical Methods, and Drug Delivery Nanosystems. Crit Rev Anal Chem 2023; 53:1080–93. https:// doi. org/10. 1080/ 10408347.2021.2007469.
  10. Smith ME, Elstad M. Mitomycin C and the endoscopic treatment of laryngotracheal stenosis: are two applications better than one? Laryngoscope 2009; 119:272–83. https:// doi. org/10. 1002/lary. 20056.
  11. Abraham LM, Selva D, Casson R, Leibovitch I. Mitomycin: clinical applications in ophthalmic practice. Drugs 2006; 66:321–40. https://doi. org/ 10.2165/00003495-200666030-00005.
Iranian Journal of Otorhinolaryngology
Volume 37, Issue 5
September and October 2025
Pages 247-252

Files

Share

How to cite

Statistics