Intraarterial cancer chemotherapy, arterial occlusion, and Tc-99m macroaggregated albumin perfusion scintigraphy

Intraarterial infusion of anticancer drugs has been used to produce an increase in local tumor effect coupled with a reduction in systemic drug toxicity. In this method of treatment, cytotoxicity within the tumor is dependent on drug concentration and duration of exposure. Concentration depends on the amount of blood flow to the tumor, the intratumoral disposition of the drug and the required metabolic alterations of the chemotherapeutic agent. Various clinical studies have supported the pharmacologic advantages of regional chemotherapeutic infusion. At our institution arterial infusion has been effective in prolonging survival in hepatic cancer, melanomas, bone and soft-tissue cancers, and carcinomas of the bladder. However, the survival gains have been of the order of months, not years, and ways are needed to enhance the dichotomy between increased tumor effect and reduced systemic toxicity to improve therapeutic results. One method of achieving this goal is intraarterial infusion of chemotherapeutic agents combined with occlusion of the arterial supply to the tumor