Catheter implantation for intra-arterial chemotherapy of malignant tumors of the head and neck

Tumors of the head and neck are mainly squamous cell carcinomas of varying differentiation. If the tumor is advanced (T3-T4) or distant metastases are present, the tumor is often to be regarded as inoperable. If cure is unlikely or substantial functional impairment is to be expected, surgery may no longer seem reasonable, even for tumors limited to one side. Since either radiotherapy or chemotherapy alone or in combination are often disappointing or have considerable side-effects, it seems reasonable to try to inhibit malignant cell growth by administering a cytostatic agent by intra-arterial "superselective" chemotherapy using an implantable catheter. The method is simple, and the patients may also receive combined radiotherapy if necessary. Furthermore, ambulant treatment is possible, with a substantially reduced risk of infection. This is an advantage compared with other catheter techniques, particularly in view of the restricted expectation of life of patients with advanced tumor. The disadvantage of "A-port implantation" is that chemotherapy can only start after complete wound healing.