TY - CHAP M1 - Book, Section TI - Regional Cancer Therapy: Isolation Perfusion, Isolation Infusion, and Local Ablative Techniques A1 - Alexander, H. Richard A1 - Kesmodel, Susan B. A1 - Fraker, Douglas L. A2 - Morita, Shane Y. A2 - Balch, Charles M. A2 - Klimberg, V. Suzanne A2 - Pawlik, Timothy M. A2 - Posner, Mitchell C. A2 - Tanabe, Kenneth K. PY - 2018 T2 - Textbook of Complex General Surgical Oncology AB - Regional cancer therapies are treatments that direct a therapeutic intervention to a cancer burdened organ or region of the body; they have the collective advantage of intensifying a treatment to a site of known disease while avoiding unnecessary systemic toxicity. They are most beneficial in circumstances where the tumor biology is favorable; that is, the site of regional metastatic spread is recognized to be the sole or life-limiting component of the patient's disease. Two general categories of regional therapy include vascular infusion or perfusion and local ablation. Vascular isolation and perfusion of a cancer-bearing organ or region of the body using a recirculating extracorporeal perfusion circuit has been in clinical use for almost 50 years. Isolation perfusion was initially applied under normothermic conditions with chemotherapeutics alone and subsequently mild-to-moderate hyperthermia (38.5°C to 42°C) became a routine component of treatment when it was shown to be associated with improved response rates.1 In the early 1990s there was renewed interest in isolation. Most recently, there has been interest in the development of percutaneous techniques of isolated limb or liver infusion. The use of local ablative therapies such as radiofrequency ablation or irreversible electroporation has become increasingly utilized as a strategy to obliterate limited sites of disease in liver or other tissues. This chapter reviews the principles and techniques of isolation perfusion and infusion as well as the current status of these modalities in clinical practice. The various components of therapy that are routinely used are also reviewed. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - hemonc.mhmedical.com/content.aspx?aid=1145755639 ER -