Progress in Regional Cancer Therapy by L. Domellöf (auth.), Professor Dr. Raimund Jakesz, Professor

By L. Domellöf (auth.), Professor Dr. Raimund Jakesz, Professor Dr. Hugo Rainer (eds.)

Present wisdom in local melanoma remedy is gifted during this quantity. the most recent examine addresses the questions of optimum drug improvement, the easiest galenic shape and agenda to manage tissue distribution on the tumor website and effective therapy of particular anatomical regions.

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More than 50% of the specimens with poor TS inhibition had low FdUMP levels. Inadequate cofactor (methylene tetrahydrofolate, CH 2 FH 4 ) levels were present in only about half of the tumors. ----. • • 1000 • ... ----, 200 In. ----. 300 • • •o PRPP Uracil Phosphoribos yltrans fer ase (pmol/mg/hl o o 200 100 •••• IJ, •••• Fig. 2. Levels of 5-FU anabolic enzymes in secondary liver tumors and normal liver, Tissue specimens were obtained by biopsy from patients undergoing laparotomy. PRPP, phosphoribosyl pyrophosphate; • tumor; 0 normal liver; /', mucosa Table 1.

The preliminary results after 2 years showed that survival was better, though not significantly so, in the perfused group. However, after 5 years the survival rate had become worse. Regarding the number of liver metastases in our trial, the perfusion group is as bad as the control group (Table 3). If the liver metastases are resectable we always extirpate them and introduce a Port-A-Cath catheter (Pharmacia) into the umbilical vein or the portal system. In the 16 patients whose metastases were removed we administered cyclic chemotherapy with mitomycin-C (lOmg/m2) as a bolus and 5-FU (1 g/m 2) continuously for 7 days, if possible every 6 weeks over a period of 1 year.

All were treated with hepatic artery ligation and portal vein infusion of chemotherapy (mitomycin C and 5-FU). Two patients (10%) died within 1 month postoperatively. The remaining 17 patients all improved clinically and demonstrated a marked decrease in carcinoembryonic antigen (CEA) levels. Based on follow-up physical examination, liver function tests, computed tomographic scan and/or laparotomy, there were two complete responses, ten partial responses, four improvements, and one indeterminate result, giving an objective response rate of 63%.

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