Chemotherapy for Tumors of Chest Wall and Base of Neck by Arterial Infusion

Chemotherapy for Recurrent Carcinoma of the Breast

“…By gaining entrance to the subclavian artery via either inter nal mammary artery, the surgeon is able to avoid cutting through recurrent disease attend ant with its problems of failure to heal, infection, etc. This artery can be cannulated under local anesthesia and has been described by us in detail previously [8]. In brief, a parasternal incision is made one fingerbredth from the edge of the sternum over the 2nd to 3rd costal cartilage.…”

“…For intracutaneous or subcutaneous lesions of either hemithorax, a catheter is inserted into the subclavian artery via a branch of that artery in the neck [8]. By utilizing an ap proach similar to that for scalene node biopsy, either the transverse cervical or transverse scapular artery is found, ligated distally and the catheter passed proximally into the sub clavian artery.…”

Treatment of Squamous Cell Carcinoma of the Head and Neck by Chemotherapy

“…The importance of anatomic location has been emphasized by Nahum [29], From his work it is possible to list the predicted efficacy of infusion of specific sites relative to the proportion of the blood supply provided by the external carotid system (table I). Humphrey [20], however, has expanded the anatomical limits of in fusion by utilizing the thyrocervical trunk. He does this by retrograde cathet erization of the transverse scapular or transverse cervical artery.…”

“…The catheter should be secured in place with sutures, although suturing a rubberband around the artery as described by Webb et al [50], to choke off the ves sel when the catheter is extracated has proved most useful in the author's Tabic I. Relationship of anatomic sites of primary squamous cell carcinoma to response [20] hands. An arteriogram or infusion of 5% fluorescein and illumination with U V light as described by Sullivan [48] should be done to insure proper cath eter location.…”