Intraarterial chemotherapy as neoadjuvant treatment of oral cancer

Neoadjuvant chemotherapy in patients with primary squamous cell carcinomas of the oral cavity should lead to high remission rates whilst having low mo rbidity. Efficacy can also be enhanced hy treating small tumour stages. As part of a multi-modality therapy of all stages of primary oral cavity carci noma, 103 patients were treated with neoadjuvant intraarterial (i,a,) chemo therapy. After regimen A with 100mg/m(2) i,a, cisplatin followed by 5 day c ontinuous intravenous infusion of 5-fluorouracil (1 g/m(2) per day) in 36 p atients, an i,a, high pressure chemo-perfusion with a dose of 150 mg/m(2) c isplatin was used with simultaneous intravenous fusion of 9 g/m(2) sodium t hiosulfate (regimen B, 67 patients). Subsequent treatment comprised radical surgery and simultaneous radiochemotherapy with docetaxel. Partial and com plete remissions were found in 80.6% (regimen A) and 67.2% (regimen B) of c ases, tumour growth was inhibited in 11.1% and 31.3%, Very low toxicity cou ld be shown especially in regimen B, 66.7% and 74.6% of patients could be o perated on radically. Survival rate was 61.1% (regimen A, 22.7 months of me an observation time) and 79.1% (regimen B, 8.4 months). Patients with high- grade remissions seemed to have a survival advantage. Neoadjuvant i,a, chem otherapy with cisplatin, especially in its high dose variant, is a practica l therapeutic tool for the treatment of all stages of primary oral cavity c arcinoma. (C) 1999 European Association for Cranio-Maxillofacial Surgery.