An Arterial Injection Method through Inferior Thyroid Artery for the Treatment of Laryngeal Cancer

Abstract

We have tried to apply anti-cancer drugs by the method of arterial injection to inferior thyroid artery for the treatment of the laryngeal cancer. The patient was a 66-year-old Japanese male with the cancer mainly located in the posterior commissure of the larynx. After truncus thyreocervicalis and its branches were exposed, the Hakko's teflon tube with the outside diameter 1mm was retro-catheterized through transversa colli artery. We are always mindful of that an anatomical variety exists on truncus thyreocervicalis and inferior thyroid artery. Using dyestaining method we confirmed that the end of the catheter was definitely in truncus thyreocervicalis and not in subclavian artery. Thereafter, the catheter was fixed. It was then lead to the outside of the skin on the shoulder. Other arteries except ascending colli artery, which supplies partially the spiral cord, were ligated in expectation of effective arterial injection through inferior thyroid artery. Two modes of the treatment consisting of 5-FU arterial injection and irradiation were combined. The total dosage of the anti-cancer drug was 3,125mg and irradiation dose was 2,200 rads. The tumor in the posterior commissure disappeared, but it remained in the farther anterior part of the commissure. This suggests that inferior thyroid artery might supply blood only to the region of posterior crico-arytenoid muscle, namely the region of the posterior commissure. Therefore, we directly injected 5-F5 into the cricothyroid branch artery using Thermo 27 G needle under microscope and simultaneously employed the radiotherapy.