Selective Intra-Arterial Chemoinfusion with Palliative Purpose in Patients with Relapses of Squamous Cell Carcinoma of the Head and Neck after Completed Chemoradiotherapy

Introduction: The squamous cell carcinoma of the head and neck treatment remains an urgent and still unresolved problem of modern oncology. We have developed an original method of individualized volume-controlled transient hypoxic selective intra-arterial chemo-infusion which was compared with standard intravenous chemotherapy according to the PF scheme for the treatment of recurrent squamous cell carcinoma of the head and neck.

Material and methods: Consecutively 73 patients with the ECOG ≥ 2 status and relapses of squamous cell carcinoma of the head and neck after previous completed chemo-radiotherapy up to total dose 68-70 Gy were included in this study. In the first group consecutively 39 patients were treated by the original technique of selective intra-arterial chemoinfusion. In the second group (control group) the 34 patients were treated by standard chemotherapy by PF scheme with intravenous administration.

Results and discussion: The technical success of selective intra-arterial interventions in all patients in group 1 was 100 %. There were no differences in the frequency and severity of adverse reactions due to chemotherapy in both groups. The frequency of objective responses was 30.8 % in group 1 and 11.8 % in group 2, respectively (p < 0.01). Stabilization was observed in 59 % in group 1 and 52.9 % in group 2, respectively (p > 0.05). The rate of progression was 10.3 % and 35.3 % in group 1 and group 2, respectively (p < 0.01). The median survival rate of group 1 patients was 325 days, which is almost 2 times higher than in group 2 which made up 173 days.

Conclusion: The original technique of intra-arterial selective volume-controlled transient hypoxic chemoinfusion may be the method of choice for the treatment of recurrent squamous cell carcinoma of the head and neck after completed radiation therapy in weakened patients.

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