Combined intraarterial chemotherapy, radiation therapy, and surgery for advanced squamous-cell carcinoma of the head and neck.

From 1973 to 1978, 20 patients with T3 and T4 squamous cell carcinoma of the head and neck were treated according to a triple-therapy protocol at the University of Oregon Health Sciences Center. Intraarterial chemotherapy (IAC) with bleomycin and methotrexate was given prior to high-dose preoperative radiation therapy and then, when possible, the lesion was resected. The treatment results are presented. The initial clinical response to IAC and radiation correlated well with the findings in the pathologic examination of the resected specimen in 11 patients, but it did not correlate well with the subsequent clinical course of the patient. In view of the results of this pilot study, we do not feel that it is justified to continue IAC with bleomycin and methotrexate prior to conventional therapy in the very advanced and aggressive cancers of the head and neck. However, IAC might be justified in treating patients with operable Stage III carcinomas of the maxillary antrum.