Isolated Lung Perfusion for the Treatment of Pulmonary Metastatic Disease: a Review

Abstract

Isolated lung perfusion with chemotherapeutic agents is an experimental technique for the treatment of lung metastatic disease from certain solid tumours. The technique had already been developed in the late 1950s but underwent a revival in the early 1980s. By that time, experimental work in large and small animals induced extensive clinical work with different agents such as doxorubicin, tumour necrosis factor, melphalan and cisplatin for which safety profiles and maximal tolerated doses were defined. A review of current work is presented in this article.

Transpulmonary Chemoembolization: A Novel Approach for the Treatment of Unresectable Lung Tumors

“…23,24 This idea was reintroduced in the 1980s and tested as a potential alternative to systemic chemotherapy. 25,26 With isolated lung perfusion, it is possible to obtain drug concentrations near the tumor site twice as high as those achieved with systemic chemotherapy with only 25% of the systemic dose. 27 Several recent animal studies have reconfirmed that tumor drug concentrations and therapeutic efficacy are significantly higher 28,29 with isolated lung perfusion than with systemic chemotherapy.…”

Transpulmonale Chemoembolisation (TPCE) als palliatives Behandlungskonzept bei primären Lungentumoren

“…After evaluation of morphologic criteria, a mean volume regression of 12.1 ml (40.4 %) of the embolized areas was achieved in four patients (23. [10]. Aus diesem Grunde wurde bereits in den 50er-Jahren das Konzept der isolierten Lungenperfusion entwickelt [11]. Dieses sieht eine Kanülierung der A. pulmonalis für den Zufluss zum Patienten sowie der beiden Lungenvenen für den Abfluss aus dem Patienten vor, wodurch ein geschlossener Perfusionskreislauf entsteht.…”