Jane C. Wright

A Simplified Technic for Regional Perfusion REPORT OF ITS USE IN A SERIES OF TWENTY-THREE CASES OF MALIGNANCIES OF THE HEAD AND NECK

I N 1957 regional perfusion of human cancers with chemotherapeutic agents was first described [I]. Since then several investigators have reported on their experience with the technic in tumors of the head area [2-41. The methods employed have been essentially those developed by Creech and his co-workers [T]. These incIude the use of a heart-lung machine for maintaining an extracorporeal vascular circuit through the tumor-bearing area. In an attempt to overcome some of the technical problems and perhaps increase the versatility of the perfusion concept a simplified technic has been developed. With it the oxygenator, blood for priming, and the heavy equipment are eliminated but the essential principles of perfusion therapy are maintained. Since December 1958, sixty-one perfusions have been performed for neoplasms of various areas. Twenty-eight have been by the simplified, nonoxygenated technic. (Table I.) This report concerns the technic and its use in a series of twenty-three perfusions of the head and neck area.

Simultaneous surgical and perfusion therapy for operable cancers of the head and neck area

Abstract A new method of treating cancers of the head and neck area by a combination of regional perfusion and surgical extirpation has been presented. The chemotherapeutic agents are perfused at the time of regional lymph node dissection. This attempt to reduce the chance of recurrent disease is made without interfering with some of the basic tenets of cancer surgery. That is, by not violating the cancer field or delaying definitive surgery. Wound healing can be expected to proceed unimpaired and local non-neoplastic tissue necrosis prevented at the doses proposed. By using the nonoxygenated pump system fifteen to twenty minutes are added to the operation, but no additional blood for priming or extra personnel are needed. An additional operation is not required for these perfusions. Experience with twelve such simultaneous perfusions in ten patients has led to a safe and simple technic. Tests of its efficacy will come in time from controlled studies on selected cases.

Chemotherapy of Cancer

This is probably the best book on the chemotherapy of cancer produced to date. It summarizes the topic well and gives the experiences of many of the outstanding pioneers in this field. The authors have employed many of the numerous drugs which have been available since the late 1940s in the treatment of human tumors; they discuss the common tumors and some of the rare ones on which progress has been made, and review their individual experiences. Treatments and dosage schedules vary from physician to physician and among institutions, and the authors have their favorites. Thus, a wide range of experience is related. Most of the recommendations and observations have been confirmed. Chapter 1 represents an exceptionally excellent review of the mechanisms of action of the anti-cancer drugs available today, both investigational and noninvestigational. The total pharmacology known in this area is clearly and concisely presented. The book gives details