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Cancer Chemotherapy by Infusion

  • Kartonierter Einband
  • 700 Seiten
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Chemotherapy for-cancer is in a state of evolution. Because some cancers can now be cured with chemotherapy as a singular modality... Weiterlesen
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Chemotherapy for-cancer is in a state of evolution. Because some cancers can now be cured with chemotherapy as a singular modality, this therapy can no longer be viewed as simply a palliative contribution. Chemotherapy has assumed an important role as an adjuvant to other modalities, including both surgery and radiation therapy. For some tumors, the primary application of chemotherapy in a combined modality approach to curative therapy has resulted in the application of less radical surgery while achieving substantial of relatively rare tumors such as cure rates. Nonetheless, with the exception childhood tumors, hematologic malignancies, and testicular cancer, the effec tiveness of chemotherapy in most tumors is severely limited. At the cellular level, greater understanding of the specific mechanism of tumor cell killing and of the phenomenon of drug resistance are elusive, critical ingredients in the improvement of effectiveness in cancer chemotherapy. Prolonging the exposure time of the tumor cell to drugs is a concept that was addressed in the early phases of the development of chemotherapy. How ever, technological limitations inhibited the broader application of chemother apy by infusion until recent years. Also, the convenience of intermittent ther apy on an outpatient basis, with the predominant theory of drug effect based on a dose response as well as the proven effectiveness of this schedule in some tumors, has slowed the process of subjecting infusion chemotherapy to the rigors of clinical trials.


Section I - Rationale and Technical Aspects.- 1. Introduction to the Concept and Practice of Infusion Chemotherapy.- Categories of Infusion Chemotherapy.- Rationale for Systemic Infusional Chemotherapy.- Technologic Impetus to Infusional Chemotherapy.- Current Clinical Status of Infusional Chemotherapy.- Summary.- 2. Experimental Rationale for Continuous Infusion Chemotherapy.- Antimetabolites.- Plant Alkaloids.- Alkylating Agents.- Antineoplastic Antibiotics.- Miscellaneous Agents.- Summary.- 3. The Clinical Pharmacology of Infusional Chemotherapy.- Pharmacokinetics of Infusional Therapy.- Regional Therapy.- 4. Drug Administration Systems for Infusion Chemotherapy.- Patient Worn Extracorporal Systems.- Implantable Infusion Systems.- Alarms and Performance Status Information.- 5. Technical Aspects of Vascular Access for Infusional Chemotherapy.- Introduction-Venous Access.- Arterial Access.- Summary.- 6. Nursing Management of Infusion Catheters.- Hickman Catheters.- Subclavian Catheters.- Implantable Venous Access Portals.- Special Considerations.- Management of Local Skin Effects.- Complications Associated with Subclavian Catheters.- Detection and Management of Infection.- Hepatic Artery Catheters.- Implantable Infusion Pump.- Pump Complications.- Conclusion.- 7. Pharmaceutical Issues in Infusion Chemotherapy Stability and Compatibility.- Concepts and Definitions.- Procedures for Study of Stability.- Short-Term Stability.- Long-Term Stability.- Admixtures.- Conclusion.- Section II - Chemotherapeutic Agents.- 8. Antipyrimidines: 5-Fluorouracil and 5-Fluoro-2?-Deoxyuridine.- Clinical Trials of Fluorinated Pyrimidines Given by Short- and Long-Term Intravenous Infusions.- Studies of Protracted Venous Infusion of the Fluorinated Pyrimidines.- 9. Mexthotrexate.- Theoretical Considerations.- Clinical Investigations.- Summary.- 10. Anthracyclines.- General Considerations.- Methods of Doxorubicin Infusion.- Therapeutic Implications of Continuous Venous Infusion of Doxorubicin.- Anthracycline Analogues.- 11. Cisplatin, Platinum Analogues, and Other Heavy Metal Complexes.- Cisplatin.- Intra-Arterial Cisplatin.- Platinum Analogues.- Gallium Nitrate (Ga(NO3)3).- Spirogermanium.- 12. Cytosine Arabinoside.- Background.- Clinical Research.- 13. Periwinkle Alkaloids I: Vinblastine and Vindesine.- Background.- Rationale for Infusion.- Vinblastine (Phase 1 Trials).- Vinblastine (Phase 2 Trials).- Vindesine (Phase 1 Trials).- Vindesine (Phase 2 Trials).- Conclusions.- 14. Periwinkle Alkaloids II: Vincristine.- Clinical Trials.- Results.- Discussion.- 15. Bleomycin.- Mechanism of Action.- Pharmacology.- Bleomycin Toxicology.- Animal Studies.- Pharmaceutical Data.- Clinical Trials in Humans.- Testicular Cancer.- Head and Neck Cancer.- Cervical Cancer.- Lymphomas.- Other Tumors.- Discussion.- 16. The Epipodophyllotoxins: VP-16 and VM-26.- Mechanism of Action.- Clinical Pharmacology.- Schedule Dependency.- Pharmaceutical Data.- Clinical Trials.- Discussion.- 17. Alkylating Drugs and Other Agents.- Alkylating Agents.- Antimetabolites.- Miscellaneous Cytotoxic Agents.- Summary.- 18. Investigational Agents.- 19. Protracted Infusional Chemotherapy.- Preclinical Pharmaceutical Studies.- Phase 1 Studies.- Summary of Phase 1 Trials of Protracted Infusion Chemotherapy.- Phase 2 Studies.- Phase 3 Trials.- Section III - Systemic Infusion by Tumor Category.- 20. Head and Neck Cancer.- Background.- Rationale of Infusion Chemotherapy.- Clinical Trials.- Summary.- 21. Esophageal and Anal Cancer.- Preoperative Versus Postoperative Therapeutic Concepts.- Anal Canal Tumors.- Squamous Cell Cancer of the Esophagus.- Present and Future Status of Anal and Esophageal Cancer Therapy.- 22. Colorectal Cancer.- Standard Bolus 5-Fluorouracil.- 5-Fluorouracil and FUDR Continuous Infusion.- Other Agents.- Infusional 5-FU Concomitant with Radiation.- Adjuvant Infusional Chemotherapy.- Summary.- 23. Gastric, Pancreas, and Biliary Tract Cancer.- Conventional Treatment.- Chemotherapy by Infusion for Stomach, Pancreas, and Biliary Tract Carcinoma.- Intra-Arterial Therapy.- Discussion.- 24. Breast Cancer.- Infusion Studies of Doxorubicin.- Continuous Infusion of Vinca Alkaloids.- Continuous Venous Infusion Trials with Other Drugs.- 25. Infusion for Hematologic Malignancies.- Vinca Alkaloids.- Epipodophyllotoxins.- Antibiotics.- Alkylating Agents.- Antimetabolites.- Metals.- New Drugs.- Combination Chemotherapy.- Conclusions.- 26. Lung Cancer.- Theory and Background.- Modalities of Administration of DDP-BLM and Associated Drugs.- Modalities of Administration of 1 or 2 Complementary Drugs.- Secondary Therapy Protocols in Relation to Clinical Situations.- Results.- Discussion.- Other Trials of Infusion Chemotherapy.- Summary.- 27. Testicular Cancer and Other Tumors of the Male Genitourinary Tract.- Vinblastine and Bleomycin Combination in the Management of Germ Cell Tumors.- Prostatic Carcinoma.- Urothelial Tumors.- 28. Gynecologic Malignancy.- Cancer of the Cervix.- Ovarian Cancer.- Other Sites.- Conclusion.- 29. Soft Tissue and Osteogenic Sarcomas.- Standard Bolus Chemotherapy.- Regional Infusion Chemotherapy.- Systemic Infusional Chemotherapy.- Combined Modality Therapy.- Summary and Conclusions.- 30. Uncommon Tumors.- Malignant Melanoma.- Hepatocellular Carcinoma.- Apudomas.- Thymoma.- Summary and Commentary.- Section IV-Regional Infusion.- 31. Head and Neck Cancer.- Regional Infusion: Background and Experience.- Limitations and Complications of Regional Infusion.- Use of External and Implantable Pumps.- Summary.- 32. Regional Infusion for Metastatic Liver Tumors.- Incidence and Natural History of Metastatic Liver Tumors.- Rationale and Methodology of Infusion Chemotherapy via Hepatic Artery.- Therapeutic Results of Hepatic Arterial Infusion Chemotherapy.- Hepatic Artery Ligation (HAL) and Arterial Infusion Chemotherapy.- Portal Vein Infusion Chemotherapy.- Transcatheter Embolization and Arterial Infusion Chemotherapy.- Summary and Conclusions.- 33. Hepatic Arterial Infusion Chemotherapy: Clinical Trials with the Implantable Pump.- Nonrandomized Clinical Trials.- Prospective Randomized Controlled Trials.- National Cancer Institute Trial.- Summary.- 34. Regional Infusion for Primary Hepatic Carcinomas.- The UAB Experience with Regional Adriamycin Chemotherapy for Hepatoma Patients.- Experience at M.D. Anderson Hospital and Tumor Institute.- Summary.- 35. Hepatic Artery Ligation and Portal Vein Infusion.- Effects of Hepatic Artery Ligation on Liver Parenchyma.- Effects of Hepatic Artery Ligation on Liver Metastases.- Effects of Portal Infusion on Liver Metastases.- Effect of HAL and Portal Infusion on Liver Metastases.- Conclusion.- Section V-Special Categories of Infusion Chemotherapy.- 36. Regional Infusion for Brain Tumors.- Clinical Experience.- Review of the Literature.- 37. The Clinical Use of 5-Fluorouracil and Other Halopyrimidines as Radiosensitizers in Man.- Preclinical Studies.- Pharmacology of Infused 5-FU.- Clinical Studies of 5-FU Radiosensitization.- Current Clinical Status of Infused 5-FU and X-rays.- Current Clinical Status of BUDR and IUDR.- Conclusions.- 38. Intraperitoneal "Belly Bath" Chemotherapy.- Intracavitary Sclerosing Therapy.- Pharmacokinetic Rationale for Intraperitoneal Chemotherapy.- Acute and Chronic Toxicities of Intraperitoneal Chemotherapy.- Trials of Single-Agent Intraperitoneal Chemotherapy.- Combination Intraperitoneal Chemotherapy.- Conclusion.- 39. Intraventricular Chemotherapy for Leptomeningeal Carcinoma.- Clinical Presentation of Carcinomatous Meningitis.- 'Concentration x Time' Therapy in Carcinomatous Meningitis.- Drug Delivery System.- Drug Administration and Toxicity.- Clinical Management.- Clinical Experience.- Case Presentations.- Conclusions.- 40. Intravesical Chemotherapy for Bladder Tumors.- Characteristics of Superficial Bladder Cancer.- Clinical Presentation and Diagnosis.- Staging and Classification.- Mechanisms of Recurrence.- Risk Factors for Recurrence and Progression of Superficial Bladder Cancer.- Agents for Intravesical Therapy.- Comparative Studies.- 41. Combination Chemotherapy and Infusional Schedules.- Tactics of Combination Chemotherapy.- Combination Chemotherapy with Single-Agent Infusions.- Combination Chemotherapy Using Drug Admixtures.- Summary.- 42. Continuous Infusion Antibiotic Therapy for Neutropenic Patients.- Infection in Neutropenic Patients.- In Vitro Studies.- Experimental Animal Studies.- Human Pharmacology Studies.- Clinical Therapeutic Studies.- 43. Degradable Starch Microspheres Infusion: Basic Considerations for Treatment of Hepatic Neoplasia.- Choice of Tracer for Continuous Monitoring of DSM Treatment.- Monitor for Continuous Registration of the Effect of DSM on the Passage of Low-Molecular-Weight Substances.- Effect of DSM on the Passage of Low-Molecular-Weight Substances in the Treatment of Liver Tumors.- Effect of Portal Blood Flow in the Passage of 99mTc-MDP Injected Intra-Arterially with DSM.- Importance of AV Shunting to the Effect of DSM.- Kinetics of the Passage of 99mTc-MDP Injected with DSM.- Conclusion.- 44. Cost-Effectiveness in Cancer Chemotherapy.- Defining the Cost Basis.- Comparative Costs of Infusion Chemotherapy.- Cost Comparisons: Bolus Versus Infusion Chemotherapy.- Summary.- 45. Adjuvant Applications of Infusional Chemotherapy.- Colon and Rectal Cancer.- Applications of Adjuvant Infusional Chemotherapy to Other Tumors.- Protochemotherapy.- Summary.- References.


Titel: Cancer Chemotherapy by Infusion
EAN: 9789401079327
ISBN: 978-94-010-7932-7
Format: Kartonierter Einband
Genre: Medizin
Anzahl Seiten: 700
Gewicht: g
Größe: H254mm x B254mm x T178mm
Jahr: 2011
Auflage: Softcover reprint of the original 1st ed. 1987



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