Local delivery of chemotherapy: a supplement to existing cancer treatments. A case for surgical pastes and coated stents.

摘要: Abstract Local application or direct tumor injection of chemotherapeutic drugs has been proposed as a method by which local drug concentrations can be maximized in the immediate environment while systemic exposure and non-target organ toxicity is minimized. Multiple opportunities are available to combine delivery with widely practised, existing medical surgical therapies. Surgical interventions, including both open laparoscopic procedures, allow physician directly visualize manipulate pathological tissues. Intraoperative placement implantable therapeutic compounds (barriers prevent adhesions, sustained-release antibiotics, tissue `glues' hemostatic agents) at near disease site increasingly common practice. Less invasive therapies assisted diagnostic imaging (fluoroscopy, ultrasound, CT MRI scanning) have made accurate needle catheter for drainage (abscesses, cysts, obstructions), (contrast media, pharmacological agents, embolic purposes (endoluminal stents, venous filters) practised interventional procedures. This article describes polymer-based paste we developed time surgery reduce recurrence resection sites polymer-coated stent use palliative management malignant obstruction improve effective lifespan device (e.g., esophageal, biliary, prostate, pulmonary disease). Despite growth therapy other states, regional cytotoxic not deployed malignancy due clinical bias that will limited utility what considered disease. In above manner, could incorporated into protocols designed enhance, replace, efficacy treatment options.