Preoperative intra-arterial chemotherapy.

J. F. Huth, F. R. Eilber

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The major factors affecting prognosis of patients with soft tissue sarcomas are local control, size of the primary tumor, and the grade of the tumor. The only factor that can be influenced following appropriate diagnostic procedures is local control. Surgery alone, even radical surgery or amputation, is insufficient to control large, poorly differentiated tumors in many cases. Preoperative therapy has been shown to be a highly effective method for local disease control. Intra-arterial therapy appears to have several advantages in the treatment of extremity sarcomas. (1) Intra-arterial therapy results in at least a sixfold increase in the concentration of drug in the blood perfusing the tumor. If combined with proximal occlusion of blood flow (balloon occlusion or tourniquet occlusion), the concentration of drug being delivered to the tumor may increase by 30-fold [32]. This high local concentration of chemotherapy is achieved in most cases without the high systemic toxicity that would be required by intravenous therapy. (2) Chemotherapy infusion prior to surgery allows administration of cytotoxic therapy through an undisturbed blood supply. This allows for an improved effect of therapy at the tumor margin, which is the area at risk for seeding the wound at the time of extirpative surgery. This may facilitate limb salvage in patients with bulky tumors. (3) Responses to this preoperative therapy allows an in vivo evaluation of the efficacy of the drug against the individual tumor. This may aid in determining efficacy of using the drug for postoperative adjuvant therapy. (4) Preoperative therapy allows treatment of the tumor while awaiting construction of custom prostheses, especially in patients with osteosarcomas of the extremities.(ABSTRACT TRUNCATED AT 250 WORDS)

Original languageEnglish (US)
Pages (from-to)103-110
Number of pages8
JournalCancer Treatment and Research
Volume44
StatePublished - 1989

Fingerprint

Drug Therapy
Neoplasms
Therapeutics
Sarcoma
Extremities
Balloon Occlusion
Tourniquets
Limb Salvage
Drug Evaluation
Osteosarcoma
Adjuvant Chemotherapy
Amputation
Pharmaceutical Preparations
Prostheses and Implants
Wounds and Injuries

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Preoperative intra-arterial chemotherapy. / Huth, J. F.; Eilber, F. R.

In: Cancer Treatment and Research, Vol. 44, 1989, p. 103-110.

Research output: Contribution to journalArticle

Huth, J. F. ; Eilber, F. R. / Preoperative intra-arterial chemotherapy. In: Cancer Treatment and Research. 1989 ; Vol. 44. pp. 103-110.
@article{43e5797f364a4973ad88e39cdb93b075,
title = "Preoperative intra-arterial chemotherapy.",
abstract = "The major factors affecting prognosis of patients with soft tissue sarcomas are local control, size of the primary tumor, and the grade of the tumor. The only factor that can be influenced following appropriate diagnostic procedures is local control. Surgery alone, even radical surgery or amputation, is insufficient to control large, poorly differentiated tumors in many cases. Preoperative therapy has been shown to be a highly effective method for local disease control. Intra-arterial therapy appears to have several advantages in the treatment of extremity sarcomas. (1) Intra-arterial therapy results in at least a sixfold increase in the concentration of drug in the blood perfusing the tumor. If combined with proximal occlusion of blood flow (balloon occlusion or tourniquet occlusion), the concentration of drug being delivered to the tumor may increase by 30-fold [32]. This high local concentration of chemotherapy is achieved in most cases without the high systemic toxicity that would be required by intravenous therapy. (2) Chemotherapy infusion prior to surgery allows administration of cytotoxic therapy through an undisturbed blood supply. This allows for an improved effect of therapy at the tumor margin, which is the area at risk for seeding the wound at the time of extirpative surgery. This may facilitate limb salvage in patients with bulky tumors. (3) Responses to this preoperative therapy allows an in vivo evaluation of the efficacy of the drug against the individual tumor. This may aid in determining efficacy of using the drug for postoperative adjuvant therapy. (4) Preoperative therapy allows treatment of the tumor while awaiting construction of custom prostheses, especially in patients with osteosarcomas of the extremities.(ABSTRACT TRUNCATED AT 250 WORDS)",
author = "Huth, {J. F.} and Eilber, {F. R.}",
year = "1989",
language = "English (US)",
volume = "44",
pages = "103--110",
journal = "Cancer Treatment and Research",
issn = "0927-3042",
publisher = "Springer Netherlands",

}

TY - JOUR

T1 - Preoperative intra-arterial chemotherapy.

AU - Huth, J. F.

AU - Eilber, F. R.

PY - 1989

Y1 - 1989

N2 - The major factors affecting prognosis of patients with soft tissue sarcomas are local control, size of the primary tumor, and the grade of the tumor. The only factor that can be influenced following appropriate diagnostic procedures is local control. Surgery alone, even radical surgery or amputation, is insufficient to control large, poorly differentiated tumors in many cases. Preoperative therapy has been shown to be a highly effective method for local disease control. Intra-arterial therapy appears to have several advantages in the treatment of extremity sarcomas. (1) Intra-arterial therapy results in at least a sixfold increase in the concentration of drug in the blood perfusing the tumor. If combined with proximal occlusion of blood flow (balloon occlusion or tourniquet occlusion), the concentration of drug being delivered to the tumor may increase by 30-fold [32]. This high local concentration of chemotherapy is achieved in most cases without the high systemic toxicity that would be required by intravenous therapy. (2) Chemotherapy infusion prior to surgery allows administration of cytotoxic therapy through an undisturbed blood supply. This allows for an improved effect of therapy at the tumor margin, which is the area at risk for seeding the wound at the time of extirpative surgery. This may facilitate limb salvage in patients with bulky tumors. (3) Responses to this preoperative therapy allows an in vivo evaluation of the efficacy of the drug against the individual tumor. This may aid in determining efficacy of using the drug for postoperative adjuvant therapy. (4) Preoperative therapy allows treatment of the tumor while awaiting construction of custom prostheses, especially in patients with osteosarcomas of the extremities.(ABSTRACT TRUNCATED AT 250 WORDS)

AB - The major factors affecting prognosis of patients with soft tissue sarcomas are local control, size of the primary tumor, and the grade of the tumor. The only factor that can be influenced following appropriate diagnostic procedures is local control. Surgery alone, even radical surgery or amputation, is insufficient to control large, poorly differentiated tumors in many cases. Preoperative therapy has been shown to be a highly effective method for local disease control. Intra-arterial therapy appears to have several advantages in the treatment of extremity sarcomas. (1) Intra-arterial therapy results in at least a sixfold increase in the concentration of drug in the blood perfusing the tumor. If combined with proximal occlusion of blood flow (balloon occlusion or tourniquet occlusion), the concentration of drug being delivered to the tumor may increase by 30-fold [32]. This high local concentration of chemotherapy is achieved in most cases without the high systemic toxicity that would be required by intravenous therapy. (2) Chemotherapy infusion prior to surgery allows administration of cytotoxic therapy through an undisturbed blood supply. This allows for an improved effect of therapy at the tumor margin, which is the area at risk for seeding the wound at the time of extirpative surgery. This may facilitate limb salvage in patients with bulky tumors. (3) Responses to this preoperative therapy allows an in vivo evaluation of the efficacy of the drug against the individual tumor. This may aid in determining efficacy of using the drug for postoperative adjuvant therapy. (4) Preoperative therapy allows treatment of the tumor while awaiting construction of custom prostheses, especially in patients with osteosarcomas of the extremities.(ABSTRACT TRUNCATED AT 250 WORDS)

UR - http://www.scopus.com/inward/record.url?scp=0024822969&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0024822969&partnerID=8YFLogxK

M3 - Article

C2 - 2577157

AN - SCOPUS:0024822969

VL - 44

SP - 103

EP - 110

JO - Cancer Treatment and Research

JF - Cancer Treatment and Research

SN - 0927-3042

ER -