Current Status of Transcatheter Management of Neoplasms
Transcatheter arterial infusion and arterial embolization are employed in the treatment of various neoplasms. In patients with carcinoma of the colon metastatic to the liver, the hepatic arterial infusion (HAI) of floxuridine and Mitomycinr produced a 55% partial response and a 12% complete response, as well as an improved median survival of 18 months. In metastatic breast carcinoma, a 30% response was achieved. In some cases, proximal embolization of aberrant hepatic arteries was performed to redistribute the hepatic flow to a single vessel to assist infusion of the entire liver using a single catheter. Devascularization by hepatic artery embolization has also been used to treat hepatic neoplasms. Arterial occlusion of renal carcinoma, followed after four to seven days by nephrectomy and hormonal therapy, produced a 36% response rate in 49 patients with distant metastases. In 14 patients with osteosarcoma treated with cis-diaminedichloroplatinum (CDDP) arterial infusion, a 57% response rate was achieved. Benign bone tumors were treated with arterial occlusion with a 60% response rate. Tumors of the pelvis were managed by bilateral internal iliac artery infusion using CDDP. In 21 patients with recurrent bladder carcinoma, control of pain and hematuria and prolonged survival were achieved.
Key wordsArterial infusion Arterial embolization Hepatic neoplasm Renal carcinoma Osteosarcoma Bladder carcinoma Interventional angiography
Unable to display preview. Download preview PDF.
- 3.Frei, E., III: Effect of dose and schedule on response. In: Cancer medicine, edited by J.F. Holland and E. Frei III. Philadelphia, Lea and Febiger, 1973Google Scholar
- 4.Healy, J.E.: Vascular patterns in human metastatic liver tumors. Surg. Gynecol. Obstet. 120: 1187–1193, 1965Google Scholar
- 7.Patt, Y.Z., Mavligit, G.M., Chuang, V.P., Wallace, S., Johnston, S., Benjamin, R.S., Valdivieso, M., Hersh, E.M.: Percutaneous hepatic arterial infusion (HAI) of Mitomycin C and Floxuridine (FUDR): An effective treatment for metastatic colorectal carcinoma of the liver. Cancer 46: 29–33, 1980CrossRefGoogle Scholar
- 8.Calvo, D.B., Patt, Y.Z., Wallace, S., Chuang, V.P., Benjamin, R.S., Pritchard, J.D., Hersh, E.M., Bodey, G.P., Mavligitt, G.M.: Phase I trial of percutaneous intra-arterial (I A) cis-diam-minedichloride-platinum (II) (CDDP) for regionally confined malignancies. Cancer 45: 1278–1283, 1980PubMedCrossRefGoogle Scholar
- 10.Michels, N.A.: Blood supply and anatomy of the upper abdominal organs. Philadelphia, Lippincott, 1955Google Scholar
- 16.Johnson, D.E., Samuels, M.L.: Chemotherapy for metastatic renal carcinoma. In: Cancer Chemotherapy: Fundamental concepts and recent advances (Proceedings of The University of Texas System Cancer Center, M.D. Anderson Hospital and Tumor Institute 19th Annual Clinical Conference on Cancer, 1975), Chicago, Year Book Medical Publishers, Inc. 1975, pp. 493–503Google Scholar
- 17.Johnson, D.E., Kaesler, K.E., Samuels, M.L.: Is nephrectomy justified in patients with metastatic renal carcinoma? J. Urol. 114: 27–29, 1975Google Scholar
- 18.Wallace, S., Chuang, V.P., Bracken, B., Hersh, E.M., Ayala, A., Johnson, D.: Embolization of renal carcinoma: Experience with 100 patients. Radiology (in press, 1980)Google Scholar
- 19.Wallace, S., Chuang, V.P., Green, B., Swanson, D.A., Bracken, R.B., Johnson, D.E.: Diagnostic radiology in renal carcinoma. In: Cancer of the Genitourinary Tract, edited by D.E. Johnson and M.L. Samuels. New York, Raven Press, 1979, p. 33–45Google Scholar
- 20.Chuang, V.P.: Nonoperative retrieval of Gianturco coils from abdominal aorta. Am. J. Roentgenol. 132: 996–997, 1979Google Scholar
- 22.Chuang, V.P., Wallace, S., Benjamin, R.S., Jaffe, N.: Therapeutic intraarterial infusion of Cis-platinum in the management of malignant bone tumors: A preliminary report (abstract). Presented at the 27th Annual Meeting of the Association of University Radiologists, Rochester, NY, 1979Google Scholar