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

Lindemayr, Sebastian; Lehnert, Thomas; Korkusuz, H.; Hammerstingl, Renate; Vogl, Thomas J.

doi:10.1053/j.tvir.2007.09.010

Cited by 18 publications

(18 citation statements)

References 35 publications

(38 reference statements)

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“…While chemoembolization of the liver has become routine in clinical practice, pulmonary chemoembolization, because of its perceived complex and risky nature, has received only limited attention (28,29). However, exploiting the effects of arterial chemoembolization to increase the ablative margin around lung nodules and hence optimizing the effectiveness of lung RF ablation remains a powerful rationale for combined therapy that aims to improve local disease control.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Unresectable Lung Malignancy: Combination Therapy with Segmental Pulmonary Arterial Chemoembolization with Drug-eluting Microspheres and Radiofrequency Ablation in 17 Patients

Gadaleta¹,

Solbiati²,

Mattioli³

et al. 2013

Radiology

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Section: Patient Characteristicsmentioning

confidence: 99%

Unresectable Lung Malignancy: Combination Therapy with Segmental Pulmonary Arterial Chemoembolization with Drug-eluting Microspheres and Radiofrequency Ablation in 17 Patients

Gadaleta¹,

Solbiati²,

Mattioli³

et al. 2013

Radiology

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“…These methods provide localized tumor directed treatment and alleviate many of the complicating side-effects associated with systemic (whole-body) approaches or surgical intervention. In the treatment of lung cancer, transpulmonary chemoembolization has proven successful as an interventional technique, yet has questionable impact on overall patient survival (Lindemayr et al, 2007;Vogl et al, 2013). We propose our framework of coupling tumor vascular supply to tumor metabolism as a method for screening for patients that are likely to respond to tumor directed therapies.…”

Section: Tumor Directed Therapies and Embolizationmentioning

confidence: 99%

Cancer as a Model System for Testing Metabolic Scaling Theory

Brummer

Savage

2021

Front. Ecol. Evol.

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Biological allometries, such as the scaling of metabolism to mass, are hypothesized to result from natural selection to maximize how vascular networks fill space yet minimize internal transport distances and resistance to blood flow. Metabolic scaling theory argues two guiding principles—conservation of fluid flow and space-filling fractal distributions—describe a diversity of biological networks and predict how the geometry of these networks influences organismal metabolism. Yet, mostly absent from past efforts are studies that directly, and independently, measure metabolic rate from respiration and vascular architecture for the same organ, organism, or tissue. Lack of these measures may lead to inconsistent results and conclusions about metabolism, growth, and allometric scaling. We present simultaneous and consistent measurements of metabolic scaling exponents from clinical images of lung cancer, serving as a first-of-its-kind test of metabolic scaling theory, and identifying potential quantitative imaging biomarkers indicative of tumor growth. We analyze data for 535 clinical PET-CT scans of patients with non-small cell lung carcinoma to establish the presence of metabolic scaling between tumor metabolism and tumor volume. Furthermore, we use computer vision and mathematical modeling to examine predictions of metabolic scaling based on the branching geometry of the tumor-supplying blood vessel networks in a subset of 56 patients diagnosed with stage II-IV lung cancer. Examination of the scaling of maximum standard uptake value with metabolic tumor volume, and metabolic tumor volume with gross tumor volume, yield metabolic scaling exponents of 0.64 (0.20) and 0.70 (0.17), respectively. We compare these to the value of 0.85 (0.06) derived from the geometric scaling of the tumor-supplying vasculature. These results: (1) inform energetic models of growth and development for tumor forecasting; (2) identify imaging biomarkers in vascular geometry related to blood volume and flow; and (3) highlight unique opportunities to develop and test the metabolic scaling theory of ecology in tumors transitioning from avascular to vascular geometries.

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“…As a routine approach, a 5F catheter and 7F sheath are placed transfemorally into the pulmonary artery and advanced fluoroscopically over a guidewire into a segmental pulmonary artery. Commonly, a 7-mm balloon catheter is placed 10 and chemotherapeutic agents are infused following balloon inflation. This selective catheterization results in obstruction of the arterial supply, with resultant regional ischemic necrosis of tumor while minimizing damage to the normal lung parenchyma (►Fig.…”

Section: Transpulmonary Chemoembolizationmentioning

confidence: 99%

Regional Chemotherapy of the Lung: Transpulmonary Chemoembolization in Malignant Lung Tumors

Vogl

Shafinaderi

Zangos

et al. 2013

Semin intervent Radiol

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Objectives: Upon completion of this article, the reader will be able to discuss the advantages and disadvantages of techniques providing regional chemotherapy to the lungs.Accreditation: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Tufts University School of Medicine (TUSM) and Thieme Medical Publishers, New York. TUSM is accredited by the ACCME to provide continuing medical education for physicians.Credit: Tufts University School of Medicine designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.Lung cancer is the main cause of death among all kinds of cancers.1 It is responsible for $23% of total cancer deaths. The main types of lung cancer are small cell lung cancer and nonsmall cell lung cancer. Long-term exposure to tobacco smoke causes 80 to 90% of lung cancers.2 Nonsmokers account for 10 to 15% of lung cancer cases, and these cases are often attributed to a combination of genetic factors or other exposures such as radon gas, asbestos, and pollution including secondhand smoke. AbstractStandard treatment options in patients with lung cancer and pulmonary metastases are surgery, radiotherapy, chemotherapy, and immunotherapy. For reducing clinical complications of surgery and achieving a better local response, transpulmonary chemoembolization of the lungs is a possible interventional technique in which anticancer drugs are administered directly into a tumor through its feeding vessels followed by occlusive agents that are injected through the delivery catheter for blocking the vessel. This allows a longer contact period in the tumor with a higher cytostatic drug concentration. The technique is safe and results present promising local response rates, but the influence on survival is still questionable. This article describes the current role of intravascular therapies in the treatment of pulmonary malignancies.

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

Cited by 18 publications

References 35 publications

Unresectable Lung Malignancy: Combination Therapy with Segmental Pulmonary Arterial Chemoembolization with Drug-eluting Microspheres and Radiofrequency Ablation in 17 Patients

Unresectable Lung Malignancy: Combination Therapy with Segmental Pulmonary Arterial Chemoembolization with Drug-eluting Microspheres and Radiofrequency Ablation in 17 Patients

Cancer as a Model System for Testing Metabolic Scaling Theory

Regional Chemotherapy of the Lung: Transpulmonary Chemoembolization in Malignant Lung Tumors

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