Approaching 10 years disease-free survival after isolated thoracic perfusion for advanced stage IV tonsil carcinoma: A case report

INTRODUCTION: This is a report about the first case of an advanced stage IV tonsil carcinoma treated with isolated thoracic perfusion and chemofiltration. PRESENTATION OF CASE: The tumor extended beyond the midline with bilateral lymphnode metastases. Playing on wind instruments was impossible. As a professional Jazz saxophonist he refused mutilating surgery and chemoradiotherapy. After one isolated thoracic perfusion there was substantial tumor shrinkage. After three additional cycles of carotid artery infusion with chemofiltration a complete remission has been noted without systemic or local toxicity since 9 ½ years. DISCUSSION: Knowing the often considerable long-term damage after surgery and chemoradiotherapy of head and neck tumors, some patient reject conventional therapy. Because of the steep dose response curve in cancer chemotherapy, an increased drug exposure in terms of intra-arterial short-term infusions or isolated perfusion can induce rapid remission induction without significantly affecting the quality of life. Further studies comparing regional chemotherapies with conventional chemoradiotherapy are warranted. CONCLUSION: Intra-arterially applied short-term chemotherapy may generate rapid and onlasting remissions at low side-effects.