Regional Cancer Chemotherapy of Head and Neck Tumors by Continuous Intraarterial Infusion

Abstract

The results of treatment through continuous arterial infusion of anticancer drugs in 40 patients with malignant tumors, localized in the vascular area of the external carotid artery, are reported. Most of carcinomas belonged to the oral and pharingeal cavities. The external carotid artery was catheterized directely in 5 cases and indirectely in 28 cases (mostly through the superficial temporal artery); in 6 cases the lingual artery and in 3 cases the facial artery were used. The drugs and total doses employed were as follows: amethopterin (30–150 mg in 10 cases), triethylen-thiophosphoramide (60–300 mg in 9 cases), cyclophosphamide (800–6000 mg in 8 cases), daunomycin (40–280 mg in 8 cases), mitomycin C (20–40 mg in 2 cases), nitrogen mustard (10 mg in 2 cases), busulfan (35 mg in 1 case). The arterial infusion lasted from a minimum of 4 hours to a maximum of 14 days with an average of 6–12 days. In 19 cases (46,5 %) an objective improvement with significant but incomplete regression of the tumor was obtained. The improvement lasted from a minimum of 1 month to a maximum of 8 months. In this study, amethopterin was the most active compound, but only slightly more active than cyclophosphamide and daunomycin. Six patients died because of complications secondary to therapy. The indications and the technique of arterial infusion with anticancer drugs in tumors of the vascular area of the external carotid artery are discussed, as well as the complications related with this type of treatment. The literature about this subject is also reviewed.