RT Book, Section
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.
SR Print(0)
ID 1145755639
T1 Regional Cancer Therapy: Isolation Perfusion, Isolation Infusion, and Local Ablative Techniques
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK hemonc.mhmedical.com/content.aspx?aid=1145755639
RD 2024/04/19
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.