Utilization of Special Computerized Tomography and Nuclear Medicine Techniques for Quality Control and for the Optimization of Combined Precision Chemotherapy and Precision Radiation Therapy
We have previously reported the use of a combination of precision (selective, intra-arterial) chemotherapy and precision radiotherapy for advanced pancreatic, biliary tract, and sarcomatous malignancies. There were some remarkable responses, but also a few poor responses and even some morbidity. Accordingly, we are attempting to develop methods of pre-selecting those patients whose tumors are likely to respond to such therapy, as well as methods for improving the therapeutic ratio by the rational optimization of combined therapy. Specifically, clinical tumor blood flow characteristics (which we monitor with nuclear medicine techniques) may provide useful criteria for such selection. Also, we qualitatively evaluate the drug distribution or exposure space with specialized color-coded computerized tomography images, which demonstrate spatially dependent enhancement of intra-arterial contrast in tumor and in adjacent normal tissues. Such clinical data, we suggest could improve the quality control aspects of intra-arterial chemotherapy administration, as well as the possibility of achievement of a significant therapeutic ratio by the integration of precision chemotherapy and precision radiation therapy.
KeywordsCombine Therapy Regional Blood Flow Tumor Blood Flow Therapeutic Ratio Nuclear Medicine Technique
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