The Basal And Clinical Study Of Intervenient Therapy For Head And Neck Malignant Tumors

Objective: To measure the concentration change of anticancer drugs in tissue aftertransfemoral superselective intra lingual arterial infusion embolization under DSA andintravenous injection; and to evaluate the change of liver and renal function; and todetermine the histopathologic effect of lingual arterial by different toutes ofadministration. To analyze and evaluate the therapeutic effect of intervenient therapyand infusing embolization to31 patients with head and neck carcinomas.Methods: Four dogs selected were divided randomly into group 1 (n=2) and group2(n=2). In group 1, 5-fluorouracil(5-Fu) and carboplatin(CBP) were injected firstly intodogs via vein, then transfemoral superselective intra lingual arterial infusion gelfoamembolization under DSA (digital subtraction angiography)was done with5-fluorouracil(5-Fu) and carboplatin(CBP) after 3 weeks. The lingual tissue and thebuccal tissue specimens at different time points were collected after drugsadministration each time. Drug concentrations in tissue were determined byhigh-performance liquid chromatography (HPLC). Meanwhile, at 0d,3d,5d,8d veinblood was taken to evaluate the change of liver and renal function. In group 2, thediference was that drugs were delivered firstly via intra artery, then via vein. The biopsyof the infusion lingual arteries and the noninfusion arteries was done to determine thehistopathologic effect of lingual arterial by different routes of administration. 31patients were infused with anticancer chemicals and embolized with gelfoam in lingual,intramaxillial, facial anterial.Results:â‘ The drugs concentration in the lingual tissue after intraarterial infusionembolization was higher than after injection via vein. Almost no differences of thechange of liver and renal function and no ditterences of the change of WBC, RBC, PLCwere shown between after drugs administration via arterial and vein. No consistenthistological ditterences were detected between injection and noninjection lingualarteries.â‘¡19 cases were operated in the 31 patients after intervenient therapy andinfusing embolization with reduced tumors from 10 to 60 percent. The operations werepreformed with obverse edge and little blood. 15 patients are still alive after operationnow from 1 to 9.5 years. Conclusions:â‘ The concentration of anticancer drugs in the local tissue can beincreased after transfemoral superselective intra arterial infusion embolization underDSA;â‘¡The side effects of transfemoral superselective intra arterial infusionembolization are lighter;â‘¢Intraarterial infusion embolization with carboplatin and5-Fu is a better ways in treating oral and maxillofacial malignant tumor.