Cancer Chemotherapy by Perfusion

Abstract

Publisher Summary This chapter focuses on cancer chemotherapy by perfusion. Perfusion has been employed in the treatment of cases that are inoperable because of local extension of the tumor, or when the patient has refused radical and deforming extirpative operations. Techniques of regional perfusion are based on the concept that various anatomic regions can be isolated from the remainder of the circulation, supplied with a separate, extraneous system for pumping and oxygenating the blood, and can be maintained for varying periods of time under abnormal conditions without significant systemic effect. By altering the character and temperature of the perfusing medium, the normal biochemical environment of a tumor may be selectively altered. The techniques of perfusion discussed in the chapter include lower extremity perfusion, upper extremity perfusion, pelvic perfusion, brain perfusion, perfusion of oropharyngeal area, and total body perfusion. The chapter also discusses the escape of agent from the perfusion circuit. A standard technique has been developed for determining the dose of a chemotherapeutic agent to be administered by perfusion. The effect upon normal tissues in a perfused region depends upon the amount of an agent used. The pathologic changes occurring in perfused malignant tissues vary widely. In addition to the problems which may follow any major surgical procedure, perfusion techniques give rise to special problems that call for close attention during the period after treatment. The most common complication of cancer chemotherapy by perfusion is depression of hematopoiesis. Morbidity from cancer chemotherapy by perfusion is greater than what would be expected to occur after similar surgical procedures without chemotherapy.