Abstract: Objective To determine the maximum tolerated dose of 5-Flouruorail(5-FU) via superficial temporal arterial infusion for the patients with T3/T4 nasopharyngeal carcinoma.Methods A total of 29 patients were enrolled in this study.They were treated with 5-FU plus Cisplatin.A chemotherapy cycle was designed as 21 days and all patients were treated for 2 cycles. 5-FU was administrated by pump infusion for continuous 120-hour via superficial temporal arterial.The maximum tolerated dose of 5-FU was determined by testing increasing doses on different groups of patient until the highest dose with acceptable side effects was found.Cisplatin was infused via superficial temporal artery(20mg/m~2 /d,d1-5) for all the patients.Results 5-FU induced oral mucositis in all patients.Of the 29 patients,1 patient experienced gradeⅠmucositis in group 200mg/m~2;12 patients experienced gradeⅡmucositis which included 5 in group 200mg/m~2,5 in group 300mg/m~2 and 2 in group 350mg/ m~2; 11 patients experienced gradeⅢmucositis which included 1 in group 300mg/m~2,3 in group 350mg/m~2,5 in group 400mg/m~2 and 2 in group 450mg/m~2;5 patients experienced gradeⅣmucositis which included 3 in group 450mg/m~2 and 2 in group 500mg/m~2.Five patients experienced oral mucosal pain.For the primary tumor,2 cases achieved complete remission(CR),25 achieved partial remission(PR) and 2 presented stable disease(SD),in which the overall response rate(CR + PR) was 93% .For the neck lymph nodes,the cases of CR,PR and SD were 1,16 and 0 respectively,the rest 12 were neck-node-negative,in which the CR + PR was 100%.Conclusions Superficial temporal arterial infusion with 5-FU for T_3/T_4 nasopharyngeal carcinoma is well tolerated.The maximum tolerated dose of 5-FU is 350mg/m~2.

Key words: Nasopharyngeal carcinoma, 5-fluorouracil, Intra-arterial chemotherapy, Maximum tolerated dose