Intra-arterial chemotherapy for metastatic cancer to the brain

Abstract

T HE intra-arterial infusion of chemotherapeutic agents in the treatment of cancer in \-arious localities has been used for approximately a decade. I was one of the first advoc*ates of this type of therapy and have used it extensively for patients with inoperable cancer 11,21. The technic consists of placing an indwelling catheter into the artery supplying a regional anatomic site which harbors the cancer. By infusing a chemotherapeutic agent, a larger dose can be concentrated within the cancer. The lesser amount which enters the general circulation resutts in a lesser degree of hematopoietic depression. This technic has been further refined by the development of the isolation perfusion prmciple whereby an extremity or an anatomic site is isolated from the rest of the body by Iigating its circuIation temporarily, so that any materiat introduced into the isolated anatomic site will theoretically receive a11 of a given chemotherapeutic agent. By means of an cxtracorporeal circuIation the isoIated anatomic region can be the recipient of a perfusate containing a chemotherapeutic agent, and by means of the extracorporeal circulatory apparatus a constant re-infusion of the chemical agent can be maintained for a prolonged period. Oxygenation is usually added to the perfusate to permit proper oxygenation of the isolated extremity as we11 as for its theoretic benefits in enhancing the effects of the chemotherapeutic agent. This report presents experience in efforts to infuse intraarteriaIIy or perfuse b,y extracorporea1 circuIatory measures metastat ic cancer involving the brain.