Combined intra-arterial chemotherapy and radiation therapy of tumours in the maxillofacial region

Abstract

The combination of the cytostatic drugs Bleomycin and Methotrexate has been shown to be effective for carcinomas in the maxillofacial region, where according to our observations, the simultaneous administration of Methotrexate and Bleomycin appears to lessen the side iffects of Bleomycin. So as to attain, on the one hand, a sufficiently high concentration in the tumor area, but on the other, to maintain the concentration in the rest of the body at a low level, it occurred to us to introduce the cytostatic substances into the artery supplying the mass. On a conjectural stochastic basis, a combination of these drugs administered simultaneously with radiation therapy might be expected to be superior to Methotrexate and Bleomycin alone or to radiotherapy. From this standpoint, this treatment regimen was introduced at the Vienna University Clinic for Maxillofacial Surgery in September, 1973 and by September, 1978, 69 patients had been treated. In 53 of the 69 patients, the treatment took place more than one year ago. Of these 53 patients, 15 are still alive after being observed for over ohne year. Of the 30 patients who did within one year of receiving the full course of treatment, the autopsy findings in 9 are available. No evidence of residual tumor was found in two patients and marked regressive changes were noted during treatment in one case.