Factors influencing the success of arterial infusion chemotherapy for cancer of the head and neck.

Abstract Over a seven year period intra-arterial infusion chemotherapy was used for treatment of 113 patients with advanced cancer of the head and neck. The drugs employed were 5-fluorouracil, methotrexate, nitrogen mustard, and bleomycin. Infusion through the external carotid arteries and the use of low-flow infusion pumps were advantageous in avoiding serious neurologic morbidity. Regression of epidermoid, basal cell, and adenocystic carcinomas was observed. Partial or total responses were obtained in fifty-two cases, 46 per cent of the patients treated. Regression was usually brief, only 40 per cent lasting for more than two months and 7.7 per cent for more than twelve months. Response rates varied significantly with the primary site of the neoplasm. As a group, epidermoid carcinomas originating in the larynx, pharynx, parotid gland, skin and oral mucosa responded to treatment significantly more often and more often completely than did those of the tongue, lip, and maxillary antrum. Although response rates favored elderly patients, small tumors, unirradiated tumors, and tumors which recurred rapidly after excision, these tendencies failed to be confirmed statistically.