Ten Years' Experience With Intra-Aortic Infusion Chemotherapy for Gastrointestinal Malignant Tumors

Ten years' experience with intra-aortic infusion chemotherapyfor 114 patients with unresectable or recurrent gastrointestinalmalignant tumors is described. A marked response (1-B in Karnofsky'scriteria) was obtained in a type of simple peritoneal disseminationof stomach carcinoma and in a locally recurrent type of rectalcarcinoma. However, the overall response rate was low and theduration of response was generally short for gastrointestinalmalignant tumors. The rationale of chemotherapy by the intra-aorticroute is to enhance the antitumor response and to reduce drugtoxicity as compared with that by the intravenous route. Thedrug of choice is 5-fluorouracil (5-FU) in intraaortic continuousinfusion. As far as 5-FU is concerned, no toxic manifestationwas observed in most cases. However, the major complication.i.e. aortic perforation at the level of an indwelling cathetertip, which is attributed to the chemical action of 5-FU, occurredin two cases. Cancer chemotherapy is discussed on the basisof our experience with intra-aortic infusion treatment with5-FU. Our previous results suggest that the drug sensitivityof individual cancer tissues is the most important factor.