Induction chemotherapy: to downgrade aggressive cancers to improve curability by surgery and/or radiotherapy

摘要: Abstract Induction chemotherapy can be effective in reducing locally advanced or aggressive cancers to improve their prospects of cure by planned follow-up surgery and/or radiotherapy. Systemic (intravenous) delivery is the simplest and most readily available method administering induction chemotherapy. In some situations, a greater impact achieved delivering more concentrated dose anti-cancer agents into arterial blood supply cancer. Intra-arterial (i.a.) may not advantageous. To achieve an advantage, tumour must fully contained tissue supplied one arteries that effectively cannulated infused. The cancer also known respond better used state which they are delivered. advantages outweigh likely increased risks regional toxicity experienced personnel appropriate specialized equipment reduce any risk mistakes made exacting techniques delivery. general, systemic treating tumours without single artery supply; when certain inactive until modified body tissues (such as cyclophosphamide DTIC) used; satisfactory responses safely easily delivery; technical skills facilities for available; patient's general health, poor co-operation long-term prognosis precludes additional complexity infusion have malignancies head neck, limb, invasive stomach breast cancers. Primary metastatic liver cancers, pelvic possibly pancreatic well initial direct subject several studies. Closed circuit perfusion (Creech-Krementz), chemofiltration «stop-flow» (Aigner) limb (Thompson) complex aimed at even localized concentrations over short time span. These ongoing studies highly units. Their use designed such melanoma, sarcomas usually show response standard