Intra-arterial chemotherapy using an implantable infusion pump and liver irradiation for the treatment of hepatic metastases

Barone, Robert M.; Byfield, John E.; Goldfarb, Paul B.; Frankel, Sallie S.; Ginn, Cindy; Greer, Sherrie

doi:10.1002/1097-0142(19820901)50:5<850::aid-cncr2820500508>3.0.co;2-2

Cited by 109 publications

(8 citation statements)

References 10 publications

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“…Patients were able to function relatively normally since the system was totally implanted under the skin. This system has been found to function reliably for other investigators as well (Barone et al, 1982). The model 400 Infusaid pump has a sideport allowing direct injection into the hepatic artery catheter.…”

Section: Drug Delivery Systems For Intraarterial Usementioning

confidence: 98%

Regional chemotherapy of neoplastic diseases

Ensminger

Gyves

1983

Pharmacology & Therapeutics

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Recent developments have made regional chemotherapy a more rational endeavour. The important pharmacokinetic principles have been defined. The increase in regional exposure achieved is a direct function of a drug's total body clearance and is an inverse function of the permeability-area product (defining ease of egress) for third spaces or of the regional arterial blood flow for intraarterial infusion. Agents having appropriate properties are available. For new agents with appropriate pharmacokinetic parameters, regional chemotherapy may provide a means to examine the dose response against measurable tumors in the regions in question. The observation that most tumors are hypervascular may be crucial to the development of selective treatments using microspheres to deliver therapy in direct proportion to the density of the microvasculature. Regionally infused vasoconstrictors (epinephrine, angiotensin) may allow shunting of flow away from normal tissue toward tumor without potentially serious systemic cardiovascular effects. Investigations and applications of regional chemotherapy have been fostered immensely by the reliably and convenience of the Infusaid implantable pump and by implantable injection ports. The problem of systemic failure with regional approaches still remains but is approachable using pharmacologically rational programs aimed at delivering maximal systemic chemotherapy along with regional treatment. In hepatic arterial therapy, in particular, a randomized prospective study is being considered to examine the impact of such combined treatment versus regional therapy alone and versus systemic chemotherapy alone for metastatic colorectal cancer to liver. Thus, the future for regional chemotherapy appears exciting. There are many opportunities to apply therapeutic principles rationally with the potential of significant benefit to many patients.

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Section: Drug Delivery Systems For Intraarterial Usementioning

confidence: 98%

Regional chemotherapy of neoplastic diseases

Ensminger

Gyves

1983

Pharmacology & Therapeutics

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“…The development of implantable catheters and ports has revolutionized the use of HAIC. Previously, chemotherapy was delivered by external infusion pumps and this was associated with many complications during the prolonged infusions, including catheter dislodgement, catheter sepsis, external pump failure and variation in flow rates 29 . In addition to these complications, the external catheter system interferes with the everyday activities of patients and may result in low patient acceptance.…”

Section: Technical Issuesmentioning

confidence: 99%

Hepatic arterial infusion of chemotherapy for advanced hepatocellular carcinoma

Shao

Huang

Liang

et al. 2010

Asia-Pac J Clncl Oncology

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Treatment of advanced hepatocellular carcinoma (HCC) remains a significant problem for clinicians. Sorafenib, the only approved agent, improves survival rate, but is associated with a low tumor response rate. Alternative approaches for the treatment of advanced HCC are urgently needed. Hepatic arterial infusion of chemotherapy (HAIC) is a promising modality for the treatment of advanced HCC. Since its introduction, there have been improvements in implantable pumps, in catheter implantation and in the convenience and safety of HAIC in general. Numerous clinical studies have shown that HAIC provides moderate therapeutic efficacy with substantially favorable toxicity profiles in selected patient groups with advanced HCC. However, the lack of large randomized studies means that HAIC is not yet a well-established treatment for advanced HCC. We believe there is an urgent need for the further investigation of HAIC for the treatment of advanced HCC.

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“…Because of the duration of survival enjoyed by this patient, one could speculate that such a finding may represent sterilized hepatic metastases. This has previously been described by Barone and colleagues in metastatic colon cancer following radiation and chemotherapy [29]. In addition, histologic documentation of sterilization of solid tumors following treatment has been noted in metastases from gestational choriocarcinoma, testicular cancer, and, more recently, breast cancer [30,31].…”

Section: Discussionmentioning

confidence: 72%

Survival Following Self-Administered Chemotherapy for Liver Metastases

O’Dwyer

Minton

1988

Journal of Urology

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Fifty-three patients with unresectable liver metastases from colorectal cancer either self-administered or had a family member administer 5fluorouracil(5-FU) (12 mg/kg/day for 5 days in alternate weeks) through intraoperatively placed hepatic artery and/or portal vein catheters. Twenty percent had failed previous systemic chemotherapy. Seventeen who were symptomatic received additional radiotherapy. Metastasis was confined to the liver in 38, while 15 also had extrahepatic metastases. Median survival for those with hepatic metastases only was 21 months from diagnosis and 16 months from catheter insertion. There are three long-term survivors in this group, alive 58, 69, and 86 months, respectively, from diagnosis. Median survival for those with hepatic and extrahepatic metastases was 10 months from diagnosis and 6 months from catheter insertion. No patient in this group has survived long term. Catheter-related complications occurred in 20% of the patients; none were fatal. Drug toxicities were minor. Self-administered chemotherapy is a safe, effective, and simple method of achieving prolonged survival in patients with unresectable hepatic metastasis from colorectal cancer.

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Intra-arterial chemotherapy using an implantable infusion pump and liver irradiation for the treatment of hepatic metastases

Cited by 109 publications

References 10 publications

Regional chemotherapy of neoplastic diseases

Regional chemotherapy of neoplastic diseases

Hepatic arterial infusion of chemotherapy for advanced hepatocellular carcinoma

Survival Following Self-Administered Chemotherapy for Liver Metastases

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