PURPOSE To determine the efficacy of superselective angio-CT in the diagnosis of astrocytoma. METHODS Nineteen patients with astrocytoma had superselective angio-CT before chemotherapeutic agents were administered via superselective intraarterial infusion. CT was performed after contrast material was delivered through a microcatheter, which had been advanced into the feeding arteries of the tumor. Superselective angio-CT scans were compared with digital subtraction angiograms, conventional contrast-enhanced CT scans, and contrast-enhanced T1-weighted MR images. RESULTS Superselective angio-CT scans depicted contrast enhancement of the tumor in all of the patients and the medullary veins of the tumors in 32% of the patients. Digital subtraction angiograms showed tumor stains in 68% of the patients and the medullary veins in only 5%. Conventional CT scans and MR images showed contrast enhancement of the tumor in 89% of the patients. Superselective angio-CT scans confirmed the proper position of the catheter tip for the infusion of a chemotherapeutic agent. CONCLUSIONS Superselective angio-CT can be used to depict contrast enhancement of tumors and the vascular structures that are characteristic of astrocytomas.

http://www.ajnr.org/content/ajnr/17/6/1073.full.pdf

Superselective angio-CT of brain tumors

The efficacy of intra-arterial infusion chemotherapy (IACT) as the first step in a combined modality therapy in the treatment of locally advanced breast cancer was evaluated in a prospective clinical study consisting of 18 patients, 15 with stage IIIB, and three with stage IV breast cancer. A combined chemotherapy using adriamycin, mitomycin C and 5-Fluorouracil were administered at 3-week intervals until sufficient regression was achieved. Objective response rate was 66.6%. Among the 14 patients who received IACT for induction, plus surgery, simultaneous adjuvant chemotherapy and radiotherapy, 7 were disease-free at a mean of 19.5 (range 4-42) months. Six patients developed various relapses at a mean of 20.6 (range 12-28) months. IACT was found to be quite effective in local control. The early systemic relapse continues to be a serious problem that needs further intervention.

Intra-Arterial Infusion Chemotherapy in the Treatment of Locally Advanced Breast Cancer

Summary In recent years the management of breast cancer experienced a tendency towards breast conserving surgery combined with chemotherapy and irradiation. Surgery combined with chemotherapy for downsizing was applied in order to achieve resectability in large tumors or to keep the surgical intervention minimal. However, achievement of impressive response in terms of downstaging is a longlasting procedure, accompanied by prolonged toxic chemotherapy. In an attempt to achieve increased local drug exposure intraarterial infusion chemotherapy of the internal mammary and the subclavian artery was performed in 53 patients with primary breast cancer. The therapy consisted of six cycles of the three drug combination Mitomycin, Adriamycin and Cis-Platin. 34/53 patients had undergone local tumor excision prior to i. a. chemotherapy (IAC), 19/53 patients received induction (neoadjuvant) IAC and restaging with lumpectomy after three treatment cycles. Complete response was noted in 26 % and overall response was 74 %. A significant shift from T3/T4 stages towards T1/T2 was observed within three treatment cycles. Quality of life was generally good and most patients were able to work between the treatment cycles. Main side-effect was drugstreaming causing skin burns, which initially occurred in about 30 % and in recent years in 4 %. Local recurrence rate was 17 % and median survival was not yet reached within the follow up time of 16 years.

Subclavian artery infusion as induction and adjuvant chemotherapy for breast conserving treatment of primary breast cancer

Advances in technology and the increase in screening for breast cancer that identifies tumors at earlier stages have made it possible to destroy tumors in situ without surgery. This can also be used to treat locally advanced tumors. These locoregional ablative techniques include minimally invasive surgical as well as noninvasive ablative modalities, new radiation technologies, and regional chemotherapy. New developments in imaging modalities such as MR make these treatment opportunities more precise and reliable. The regional minimally invasive technologies provide treatment options that are physiologically, cosmetically, and psychologically more acceptable to the patient. Many of these need further investigation before they become an accepted sound practice. This paper reviews and discusses the up-to-date data and feasibility of technologies for locoregional treatment of breast cancer

Regional Breast Cancer Treatment

Forty-two patients with locally advanced breast cancer (n = 8) or recurrent breast cancer (n = 34) received regional chemotherapy (mitoxantrone 25 mg/m2 per 24 h) via the internal mammary artery or other vessels of the subclavian artery. To prevent artery thrombosis 500-1000 U heparin per hour were administered i.v. Tumour perfusion was monitored by intra-arterial angio-CT. Remission rates (CR + PR) were 100% (primary breast cancer) and 89% (recurrent tumours), respectively. Intra-arterial chemotherapy was well tolerated. No complications were noted.

[Superselective intra-arterial chemotherapy in breast cancer].

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[Superselective intra-arterial chemotherapy in breast cancer].