“…However, this concept contradicts the fact that, due to blood circulation in the lung 52,53 and the lymphatic circulation, drug concentrations have been found in the systemic circulation and surgically resected lymph nodes. 31,32,84,131,230,231,238 In addition, a high percentage of lymph nodes in the aerosol treatment groups did not show any metastasis in several studies, so it is possible that this route of administration destroys tumor cells and prevents them from trafficking from the primary subcutaneous tumor to the lungs and lymph nodes via the lymphatic system. 31,32,49,57 Nevertheless, in many of these studies, an additional intravenous chemotherapy regimen was administered, so clear conclusions cannot be drawn.…”