Studies on preoperative cancer chemotherapy. Methods of preoperative intra-arterial infusion by the use of methotrexate or vinblastine.

Abstract

For the purpose of performing combined therapy with surgery and preoperative intra-arterial infusion of methotrexate or vinblastine, polyethylene catheters were inserted into the right gastroepiploic artery of 18 patients with gastric cancer, through a small midline incision in the epigastrium. The best positioning of the catheter was decided by infusion of Evans blue. The dose schedules were approximately as follows: 1. methotrexate group: 33 mg of methotrexate were continuously infused 3 times within 36 hours before gastrectomy and 15 mg of leucovorin intramuscularly at one hour after each infusion; 2. vinblastine group: 6 mg of vinblastine were administered twice within 24 hours before gastrectomy and its 3 antidotes intravenously within one hour after the start of each infusion. Pathologic examination after surgery showed prevention of DNA biosynthesis and irreversible changes of chromosomes in cancer cells. The preoperative infusion of the drugs was accompanied by little complication in the postoperative course after gastrectomy.