A new method for intermittent hepatic arterial flow arrest has been used in combination with intraarterial 5-fluorouracil (5-Fu) for the treatment of secondary liver neoplasms in 12 patients. Polysaccharide microspheres with a half-life of 1 h were infused together with 5-Fu via a percutaneously introduced catheter into the hepatic artery. There were no significant side effects to the treatment. Clinical effects and overall survival were comparable to those of hepatic artery ligation.

No abstract

The effects of degradable starch microspheres (DSM) on mitomycin C pharmacokinetics and bone marrow toxicity were studied in a phase I1 multicenter study. Sixty-three patients with nonresectable primary or secondary liver cancer were randomized to receive either i.a. mitomycin C 15 m&m2 first, followed 5 weeks later by mitomycin C 15 m&m2 plus DSM 360 mg administered into the hepatic artery (group I) or the same treatments in the opposite sequence (group 11). In 36 out of 47 patients who received at least 2 treatments, peripheral venous blood samples were analyzed for mitomycin C pharmacokinetics on a minimum of 2 paired courses. In all patients, the area under the concentration time curve (AUC) was significantly lower when the drug was co-administrated with DSM, but the terminal half-life (t,,J of mitomycin C was unchanged. In group I the addition of DSM resulted in a significantly lowered AUC, but not in group 11. The discrepancy between the 2 groups is probably due to differences in DSM-induced intra-hepatic shunting. The addition of DSM resulted in significantly higher platelet nadir values, but unchanged white blood cell count nadir value. In conclusion, DSM reduce the systemic exposure of mitomycin C and seem to lessen the haematologic toxicity judged from a less pronounced decrease in platelets.

It was demonstrated in the pig that full-thickness wounds in the skin can be continuously treated by irrigation for several days. Irrigation was accomplished through a porous, occlusively applied dressing having two ports, one for supply and one for drainage. The fluid, delivered by means of an iv set, was sucked through the inert dressing, leaving it partially saturated, and with fluid spread evenly through its pores. Particulate matter was removed along narrow paths converging on the outlet, not showing any significant diversion. The apparatus for fluid supply and drainage was arranged to move with the animal, thus eliminating the risk of obstruction of the tubes as a result of twisting. The fluid was eliminated by one suction line, and the vacuum in the dressing maintained by another. This allowed the suction to be adjusted to a level near the atmospheric pressure.