[Improvements in intra-arterial chemotherapy]

Intraarterial (i.a.) chemotherapy of head and neck cancer is a worldwide field of clinical research which is still developing. Over the last decade several improvements have been made. This paper relates our own experiences with the so-called bypass method of i.a. chemotherapy and with some recent international developments.

Between 1989 and 1998, 28 patients with head and neck cancer received Cisplatin intraarterially via the bypass route, 24 of them with a curative intention without any pretreatment. The daily dose was 20 mg and the overall aspired dosage was about 400 mg, given over a period of about 5 weeks, followed by full dose irradiation (> 60 Gy). During these 5 weeks anticoagulation with warfarin was performed.

16 patients received the planned total dose of i.a. Cisplatin. Ten cases of non-life-threatening bone marrow depression and/or 7 cases of slight kidney insufficiency led to premature termination of the chemotherapy. Due to anticoagulation no technical failures occurred (early thrombosis of the cannulated artery), as we had experienced in the past. In 12 of 24 cases a complete remission was observed.

The bypass method is a technically well-developed method of i.a. infusion if performed by experienced personnel.