The delivery of cancer chemotherapy by constant venous infusion ambulatory management of venous access and portable pump

Abstract

Fifty chemotherapy trials with 5‐fluorouracil;31 mitomycin C;9 vinblastine;3 Adriamycin;5 and cis‐platinol2 were initiated employing constant (24‐hour) intravenous infusion for protracted periods (14–94 days). The use of the tunneled subclavian line for greater than 2200 patient days was associated with minimal complications and no instances of thrombosis or infection were observed. The use of an ambulatory infusion pump was associated with a pump efficiency of greater than 85% in 38 of 39 evaluable trials. Only four of 50 trials were associated with excess drug infusion and in no instance was a drug complication encountered. Constant infusion cancer chemotherapy is feasible, reliable, and safe. Objective tumor regression is observed but the superiority of this drug schedule over the standard intermittent bolus schedule is yet to be determined. Nonetheless, drug toxicity patterns are altered substantially and, in particular, gastrointestinal side effects of chemotherapeutic drugs may be eliminated without compromising cumulative dose.

Modeling three-dimensional invasive solid tumor growth in heterogeneous microenvironment under chemotherapy

“…We employ the hybrid model to investigate the effectiveness of two commonly used dosing strategies, i.e., constant and periodic dosing, in controlling the growth of avascular invasive solid tumors. Our model robustly reproduces the observation that constant dosing is generally more effective in suppressing primary tumor growth compared to periodic dosing, due to the resulting continuous high drug concentration [58][59][60][61] . However, the suppression of primary tumor progression does not necessarily lead to a suppression of invasive cell migration, which results in complex invasion branches emitting from the primary tumor [62][63][64][65] .…”