Get Cancer Chemotherapy by Infusion PDF

By Jacob J. Lokich M.D. (auth.)

ISBN-10: 940093193X

ISBN-13: 9789400931930

ISBN-10: 9401079323

ISBN-13: 9789401079327

Chemotherapy for-cancer is in a country of evolution. simply because a few cancers can now be cured with chemotherapy as a unique modality, this remedy can now not be seen as easily a palliative contribution. Chemotherapy has assumed an immense function as an adjuvant to different modalities, together with either surgical procedure and radiation remedy. For a few tumors, the first software of chemotherapy in a mixed modality method of healing treatment has led to the appliance of much less radical surgical procedure whereas attaining massive of fairly infrequent tumors corresponding to therapy charges. still, with the exception youth tumors, hematologic malignancies, and testicular melanoma, the effec­ tiveness of chemotherapy in so much tumors is significantly constrained. on the mobile point, higher realizing of the explicit mechanism of tumor mobilephone killing and of the phenomenon of drug resistance are elusive, severe parts within the development of effectiveness in melanoma chemotherapy. Prolonging the publicity time of the tumor phone to medicines is an idea that used to be addressed within the early stages of the advance of chemotherapy. How­ ever, technological boundaries inhibited the wider program of chemother­ apy via infusion till fresh years. additionally, the ease of intermittent ther­ apy on an outpatient foundation, with the principal concept of drug influence in keeping with a dose reaction in addition to the confirmed effectiveness of this time table in a few tumors, has slowed the method of subjecting infusion chemotherapy to the trials of medical trials.

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5-log greater cell kill with infusion than with bolus. Sikic et allikewise showed improvement of less than I-log cell kill. The strong opinions of Sikic et aI, namely that the infusion of bleomycin caused increased tumor cell kill and decreased pulmonary toxicity, have provided much of the rationale for clinical continuous infusion BLM studies. However, no similar studies have been performed to confirm the findings of Sikic et al. In conclusion, the in vitro data support the continuous infusion of BLM, whereas in vivo model systems provide equivocal support.

Gamma radiation and nitrogen mustard were originally assigned to this class, also known as radiomimetic agents. Type 2 agents are phase-specific, and thus the survival CurVI~ reaches a plateau, as there is no effect on cells that are not in the optimal phase of the 12 Experimental Rationale for Continuous Infusion Chemotherapy 13 cycle. Vinblastine and methotrexate (amethopterin) were originally assigned to this class. 1 Type 3 agents are highly cycle-specific, but are active in all or most phases of the cell cycle.

However, a 200-hour exposure at 1 ng/ml was highly cytotoxic, with only 3% survival. They tested a total of 77 tumors for VLB sensitivity. Of the 14 sensitive tumors, 42% showed sensitivity only when continuous (200-hour) exposure was used. Wells et al 62 found that even a 20-hour VLB exposure was relatively ineffective; they suggest that a minimum of 45 hours (at VLB concentrations of 1-10 ng/ml) is required for significant activity. Rupniak et al 6 and Mujagic et al 63 have obtained similar results, but used higher drug concentrations (20 ng/ml).

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Cancer Chemotherapy by Infusion by Jacob J. Lokich M.D. (auth.)


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