INDUCTION CHEMOTHERAPY FOR DOWNSIZING OF ADVANCED PRIMARY TUMORS AND METASTASES
Article provided by Medias Clinic, Germany
method of reducing locally advanced or aggressive primary cancers to improve their prospects of cure by planning follow-up surgery and/or radiotherapy. The simplest and most readily available method of administering induction chemotherapy is by systemic delivery, but in some situations a greater chemotherapy impact can be achieved by delivering a more concentrated dose of effective anti-cancer agents more directly to the region containing the cancer. This regional chemotherapy is usually best achieved by delivering the chemotherapy directly into the arterial blood supply of the cancer. The book, Induction Chemotherapy
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(figure 1), aims to present the full range of management techniques and practices used in induction chemotherapy within one accessible volume. It provides up-to- date information on the pioneering and cutting edge practices employed in different institutions and documents the advantages of integrated treatment schedules. Patient selection is discussed and each of the cancer types for which induction chemotherapy has
FIGURE 1
nduction chemotherapy is chemotherapy used as the first modality of an integrated treatment program. It can be an effective
proved important is considered in detail. These include the head and neck, limbs, invasive stomach cancers, breast cancers, liver cancers and some liver metastases, cancers in the pelvis, like bladder, cervical and ovarian cancers, pancreatic tumors and lung cancer and metastases. Regional chemotherapy represents a
substantial therapeutic factor in case of advanced and chemoresistant cancers as shown in one example of the book chapters. A patient with far advanced non-
resectable cancer of the parotid gland metastatic to the lungs, the primary too big for irradiation and non-responsive to systemic chemotherapy (figure 2) was
FIGURES 2,3
submitted to regional chemotherapy in terms of isolated thoracic perfusion with carotid artery infusion and subsequent chemofiltration for systemic detoxification. After three treatment cycles the tumor had shrunk to a resectable volume without any remarkable toxic side-effects to the patient due to chemofiltration. Figure 3 shows the patient six months (the same at twelve months) after start therapy at undisturbed quality of life. ■
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MORE INFO For more information, email
info@medias-klinikum.de or visit the website
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FIG 2 Advanced cancer of the Parotid Gland before regional induction chemotherapy
Springer Press, ISBN 978-3-642-18172-6 e-ISBN 978-3-642-18173-3, DOI 10.1007/978-3-642-18173-3, Springer Heidelberg Dordrecht London, New York
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FIG 3 Same patient six months after regional induction chemotherapy
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