REGIONAL CHEMOTHERAPY FOR RECURRENT SQUAMOUS HEAD AND NECK CANCERS THROUGH A SAPHENOUS-VEIN INTERPOSITION GRAFT

Regional chemotherapy for head and neck cancers is effective, but the intra-arterial catheter is not without problems. We interposed a segme nt of saphenous vein within the carotid system to administer chemother apeutic agents percutaneously via the arterialized venous segment. Fro m 1983 to 1990, saphenous vein interposition graft was performed after radiotherapy in 24 patients with persistent or recurrent squamous hea d and neck cancers, which were also considered unresectable. There was no operative mortality. Two patients developed thrombosed vein graft; another two had wound infection; and one patient had a neck hematoma. Cisplatin was administered percutaneously every week via the saphenou s vein graft. The response rate was 64% (complete response, 23%; parti al response, 41%), and the 5-year actuarial survival rate was 31%. The 1-year survival rates for patients with complete, partial, and no res ponse were 80%, 33%, and 13%, respectively. Saphenous vein interpositi on graft is a safe and convenient way of delivering intra-arterial che motherapy, and it provides significant palliation for patients with re current nonresectable squamous head and neck cancers after radiotherap y.