The effect of intraarterial high-dose cisplatin on lymph nodes in oral and oropharyngeal cancer.

Aim of Study: To assess the effect of strictly local treatment [intraarterial chemotherapy (iaCHT) with high-dose cisplatin and parallel neutralization] in the primary oral and oropharyngeal cancer (OOSCC) on the dependent cervical lymph nodes. Patients and Methods: Seventeen consecutive patients with OOSCC and clinically positive necks underwent a prospective blinded comparison of two pre-surgical fluor18-deoxyglucose (FDG)-positron emission tomography (PET) examinations: baseline examination 1 week before and follow-up examination 3 weeks after iaCHT. Maximal standardized uptake (SUVmax) values of lymph nodes were measured and compared with each other and histopathology. Results: The SUVmax value of the primary and all neck lymph nodes with uptake decreased significantly. Twelve/17 patients having metastases revealed significant decrease (P = 0.03), and benign lymph nodes showed non-significant decrease of the SUVmax. All neck lymph nodes with uptake and nodal metastases showed a significant reduction (P = 0.004) of standard uptake values (SUV). Conclusion: A regional effect of intraarterial cisplatin is proven. To date, it is not clear whether this is due to decreasing inflammatory reaction or a translymphatic anti-neoplastic effect.

The Antitumor Effect and Hepatotoxicity of a Hexokinase II Inhibitor 3-Bromopyruvate: In Vivo Investigation of Intraarterial Administration in a Rabbit VX2 Hepatoma Model

OBJECTIVE: The purpose of this study was to compare the antitumor effect and hepatotoxicity of an intraarterial delivery of low-dose and high-dose 3-bromopyruvate (3-BrPA) and those of a conventional Lipiodol-doxorubicin emulsion in a rabbit VX2 hepatoma model. MATERIALS AND METHODS: This experiment was approved by the animal care committee at our institution. VX2 carcinoma was implanted in the livers of 36 rabbits. Transcatheter intraarterial administration was performed using low dose 3-BrPA (25 mL in a 1 mM concentration, n = 10), high dose 3-BrPA (25 mL in a 5 mM concentration, n = 10) and Lipiodol-doxorubicin emulsion (1.6 mg doxorubicin/ 0.4 mL Lipiodol, n = 10), and six rabbits were treated with normal saline alone as a control group. One week later, the proportion of tumor necrosis was calculated based on histopathologic examination. The hepatotoxicity was evaluated by biochemical analysis. The differences between these groups were statistically assessed with using Mann-Whitney U tests and Kruskal-Wallis tests. RESULTS: The tumor necrosis rate was significantly higher in the high dose group (93% +/- 7.6 [mean +/- SD]) than that in the control group (48% +/- 21.7) (p = 0.0002), but the tumor necrosis rate was not significantly higher in the low dose group (62% +/- 20.0) (p = 0.2780). However, the tumor necrosis rate of the high dose group was significantly lower than that of the Lipiodol-doxorubicin treatment group (99% +/- 2.7) (p = 0.0015). The hepatotoxicity observed in the 3-BrPA groups was comparable to that of the Lipiodol-doxorubicin group. CONCLUSION: Even though intraarterial delivery of 3-BrPA shows a dose-related antitumor effect, single session treatment seems to have limited efficacy when compared with the conventional method.

Intraarterial chemotherapy for bulky uterine cervical carcinoma / 介入放射学杂志

Objective To evaluate the effects of intraarterial chemotherapy for bulky uterine cervical carcinoma. Methods One hundred untreated patients with stage Ⅰb-Ⅲa uterine cervical carcinoma were included in the study. Intraarterial chemotherapy was undertaken with a combination of Cisplatin (DDP) 50 mg/m 2 or Paraplatin 300 mg/m 2, Epiadriamycin (E-ADM)45 mg/m 2 one time/2ws. Results The overall response rate was 87.0%. Radical hysterectomy was performed in 73 patients with less bleeding and shorter operative time than those of untreated group. The major adversary effects were leukocytopenia, nausea, and vomiting. Conclusions Intraarterial chemotherapy is effective for preoperative treatment of uterive cesrvical cances with easier radical hysterectomy, especially for inoperable bulky ones.

Intravenous vs Selective Intraarterial ACNU Chemotherapy on Malignant Gliomas

In 17 cases of glioblastoma multiforme and 3 cases of anaplastic astrocytoma, ACNU chemotherapy was performed by intravenous(10 cases) and supraophthalmic or superselective intraarterial(10 cases) injection postoperatively combined with radiation therapy. The postoperative median survival time in 17 cases of glioblastoma multiforme was 15 months(7 cases alive), and those for intravenous(8 cases) and intraarterial(9 cases) were 16.3 months(2 case alive) and 13 months(5 cases alive) respectively. 3 cases of anaplastic astrocytoma(2 cases intravenous, 1 case intraarterial) are all alive and the average postoperative follow-up period was 22.5 months. The survival rate of patients with gliobalstoma multiforme at 18 months after operation was 47.6%, and those for intravenous and intraarterial were 57.6% and 36.5%. In an analysis of performance status at the time of 3 months following surgery, there was remarkable improvement of quality of life in 70% of glioblastoma multiforme treated. In postoperative 12 months, about 50% of gliobalstoma multiforme patients could carry their normal daily life. Systemic side effects such as leukopenia and thrombocytopenia occurred little more frequently in intravenous group than intraarterial group. But more serious local neurological complication such as visual loss(1 case) and leucoencephalopathy(1 case) occurred in intraarterial group. Platelet count were decreased maximally in the fourth week after ACUN administration.