Ho C M, Lam L K, Wei W I, Choi T K, Lam K H
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Arch Otolaryngol Head Neck Surg. 1993 Jun;119(6):608-11. doi: 10.1001/archotol.1993.01880180022003.
Regional chemotherapy for head and neck cancers is effective, but the intra-arterial catheter is not without problems. We interposed a segment of saphenous vein within the carotid system to administer chemotherapeutic agents percutaneously via the arterialized venous segment. From 1983 to 1990, saphenous vein interposition graft was performed after radiotherapy in 24 patients with persistent or recurrent squamous head 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 saphenous vein graft. The response rate was 64% (complete response, 23%; partial response, 41%), and the 5-year actuarial survival rate was 31%. The 1-year survival rates for patients with complete, partial, and no response were 80%, 33%, and 13%, respectively. Saphenous vein interposition graft is a safe and convenient way of delivering intra-arterial chemotherapy, and it provides significant palliation for patients with recurrent nonresectable squamous head and neck cancers after radiotherapy.
头颈部癌症的区域化疗是有效的，但动脉内导管并非没有问题。我们在颈动脉系统内插入一段大隐静脉，以便通过动脉化的静脉段经皮给予化疗药物。1983年至1990年，对24例持续性或复发性头颈部鳞状细胞癌患者（这些患者也被认为无法切除）在放疗后进行了大隐静脉搭桥术。无手术死亡病例。2例患者出现静脉移植物血栓形成；另外2例有伤口感染；1例患者出现颈部血肿。每周通过大隐静脉移植物经皮给予顺铂。缓解率为64%（完全缓解23%，部分缓解41%），5年精算生存率为31%。完全缓解、部分缓解和无缓解患者的1年生存率分别为80%、33%和13%。大隐静脉搭桥术是一种安全、方便的动脉内化疗给药方式，为放疗后复发性不可切除头颈部鳞状细胞癌患者提供了显著的姑息治疗效果。
