Clinical Applications of Continuous Infusion Chemotherapy and Concomitant Radiation Therapy

The first conference on concomitant infusion chemotherapy and radia­ tion therapy was organized with the intention of bringing together some of the investigators who have tested, during the last few years, the hypo­ thesis that continuous infusion chemotherapy could modulate the cytotoxic effect of radiation therapy to the point of having a strongly additive, if not synergistic activity on certain malignant tumors. This volume represents the detailed proceedings of this conference presented in a way that offers the reader a review of the on-going re­ search in the field. We have stressed a number of subjects from basic biologic research and influence of cell kinetics to the practical methods of drug delivery systems and early clinical experiences. The rationale for this new type of combined modality therapy has been presented by some of its pioneers. Early clinical investigations as well as the preliminary data of many that have not yet completely matured have also been included. The reader should look at these data with some reser­ vations. Ultimately, these results must be confirmed by larger prospective randomized studies with proper controls before becoming accepted as the treatment of choice in locally advanced tumors.

Section I Protracted Delivery of Antineoplastic Chemotherapy Agents.- A. Principles and Therapeutic Applications.- Theoretical, Clinical and Pharmacokinetic Aspects of Cancer Chemotherapy Administered by Continuous Infusion.- Pharmacology and Therapeutic Efficacy of Bleomycin Administered by Continuous Infusion.- Continuous-Infusion Adriamycin.- 5-Fluorouracil Plus Thymidine or Leucovorin by Continuous i. v. Infusion in the Treatment of Advanced Colorectal Carcinoma.- Epipodophyllotoxin and Cisplatin on Continuous Infusion Schedules.- Biodegradable Starch Microspheres (SPHEREX): A Clinical Useful Medical Device for Combined Intra-arterial Chemotherapeutic Treatment of Primary and Metastatic Cancers of the Liver.- Selective Therapy of Hepatic Cancers Using Microspheres.- B. Clinical Studies.- Preliminary Results of a Randomized Study of Intrahepatic Infusion Versus Systemic Infusion of FUDR for Metastatic Colorectal Carcinoma.- COPBLAM: Infusion Chemotherapy for Large Cell Lymphoma.- Adriamycin Continuous i. v. Infusion for the Treatment of Childhood Hepatic Malignancies, Toxicity and Efficacy: A Pilot Study Childrens Cancer Study Group.- An Uncontrolled Phase II Study of Constant Infusion Vincristine-Adriamycin.- Low Dose Ara-C by Continuous Infusion in the Treatment of Acute Non-Lymphocytic Leukemia (ANLL) and Myelodysplastic Syndrome (MDS).- The 5-Day Continuous Infusion of Cis-platinum: An Update on Toxicity Pattern.- Long Term Appraisal of the Lemon-Foley Method of Chemotherapy of Solid Tumors of the Gastrointestinal Tract.- Section II Antineoplastic Effects of Radiation Therapy and Concomitant Chemotherapy by Continuous Infusion.- A. Principles and Therapeutic Applications.- Theoretical Basis and Clinical Applications of 5-Fluorouracil as a Radiosensitizer.- Treatment of Hepatic Metastases from Gastro Intestinal Primaries with Split Course Radiation Therapy and Concomitant Infusion 5-Flourouracil.- Combined Modality Therapy with 5-Fluorouracil, Mitomycin-C and Radiation Therapy for Squamous Cell Cancers.- Treatment of Bladder Carcinoma with Concomitant Infusion Chemotherapy and Irradiation.- A Urologist’s Viewpoint: Treatment of Invasive Bladder Cancer by the XRT/5FU Protocol.- Concomitant Radiation Therapy and Doxorubicin by Continuous Infusion in Advanced Malignancies - A Phase I-II Study - Evidence of Synergistic Effect in Soft Tissue Sarcomas and Hepatomas.- Cis Platin by Continuous Infusion with Concurrent Radiation Therapy in Malignant Tumors (A Phase I-II Study).- B. Clinical Studies.- Combination of Radiation with Concomitant Continuous Adriamycin Infusion in a Patient with Partially Excised Pleomorphic Soft Tissue Sarcoma of the Lower Extremity.- Treatment of Recurrent Carcinoma of the Paranasal Sinuses Using Concomitant Infusion Cis-platinum And Radiation Therapy.- Hepatic Artery Infusion (HAI) for Hepatic Metastases in Combination with Hepatic Resection and Hepatic Radiation.- Phase II Study of Simultaneous Radiation Therapy, Continuous Infusion, 5-FU and Bolus Mitomycin-C.- Cancer of the Esophagus - Medical University of South Carolina Pilot Study.- Continuous Infusion VP-16, Bolus Cis-Platinum and Simultaneous Radiation Therapy as Salvage Therapy in Small Cell Bronchogenic Carcinoma.- Concomitant Radiation, Mitomycin-C and 5-Fluorouracil Infusion in Gastro Intestinal Cancer - A Preliminary Report.- Section III Techniques for the Administration of Chemotherapy Agents by Continuous Infusion.- Procedures for the Use of Implantable and External Pumps for Continuous Infusion Chemotherapy.- Central Line Catheter Care: The Nurses’ and Patients Perspective.- Potential Complications of Right Atrial Catheterization.- Long Term Complications of the Indwelling Central Line Catheters.