Prolonged Arterial Infusion Chemotherapy in Advanced Head and Neck Tumors

Abstract

The cases of advanced head and neck tumors treated with palliative chemotherapy by prolonged arterial infusion at the National Cancer Institute of Milan, Italy, between 1960 and 1970 are reviewed. The drugs most frequently used were: Methotrexate (alone or associated with Daunorubycin), Daunorubycin and Adriamycin. 97 infusions were performed in 92 patients and 63 had lesions suitable for evaluation. Regression occurred in 43 (68.3%): over 50% of the starting size of the tumor in 15 and under 50% in 28; 13 patients died as a result of the treatment. Side-effects were numerous and frequent and the incidence of local complications was high, especially in cases of direct cannulation, which also ensured the biggest decreases in tumor size. Cancer of the movable part of the tongue was most responsive to the treatment. Adriamycin with 88 % of regressions and Methotrexate with 73 % were the most effective drugs. The results of this series show that prolonged intra-arterial chemotherapy can yield a high regression rate in head and neck cancer but is is not devoid of serious side-effects and the incidence of local toxic and technical complications is high. Because of this and of the short duration of regression, it is doubtful whether arterial infusion represents an advance over other modes of administering chemotherapy.