[Methodical aspects of intra-arterial chemotherapy of malignant head and neck tumors (author's transl)].

A new method of intra-arterial (i.a.) chemotherapy of malignant head and neck tumors based on a vascular-surgical procedure is described. In combination with radical neck dissection the external carotid artery is prolonged end-to-end by an autogeneic saphenal vein graft and anastomosed with the common carotid artery end-to-side more proximally. After wound healing the transplant is well palpable and can easily be cannulated percutaneously, thus facilitating continuous or repeated i. a. chemotherapy of the malignant tumor. During therapy intervals the cannula should be removed. In this way, it is possible to perform i. a. cytostatic therapy over several weeks or months. All the branches of the external carotid artery not directly contributing to the blood supply of the tumor region have to be ligated during the neck dissection, in order to maintain the necessary high concentration of the drugs at the tumor site. First clinical results obtained with this method demonstrate the safety of the procedure and suggest new aspects of chemotherapy in head and neck cancer.