悪性腫瘍に対する制癌剤の局所灌流療法に関する実験的並びに臨床的研究

Cancer chemotherapy by regional perfusion utilizing an extracorporeal circuit was studied experimentally and clinically, designing to investigate the local tissue tolerance, the leakage factor, the tumoricidal effect and so on. The following results were obtained. 1. The maximum safe doses of Nitrogen mustard N-oxide, Triethylene thiophosphoramide, Carzinophilin, Mitomycin C, Actinomycin D and Toyomycin when administered by perfusion into the femoral artery of dog were 5mg/kg., 2mg/kg., 2.500 units/kg., 0.8mg/kg., 80γ/kg. and 100γ/kg. respectively. 2. Under perfusion of the hind limb for periods up to 30 minutes oxygenation of the perfusing blood has nothing to do with local tissue damage. 3. On isolation perfusion under hyperthermia (40℃) or hypothermia (5℃) utilizing a heat exchanger the normal tissue damage was higher than that of normothermia. 4. The fluctuation of concentration of the drugs and the leakage factor were determined in the perfused area and systemically by means of RISA, P(32)-labeled TSPA and bio-assay of Mitomycin C. The results obtained by RISA were always higher than those of the other two, and did not indicate accurate picture in estimation of the leakage into systemic circulation. 5. The titer of Mitomycin C was unchanged by pure oxygen insufflation for 30 to 60 minutes or by the preservation mixed with whole blood in refrigerator for ten days. 6. On perfusion of the hind limb of rabbit utilizing p(32)-labeled TSPA a reversible fixation or accumulation of the drug in the perfused area was actually proved. 7. The tumoricidal effect on Brown-pearce tumor of rabbit was much evident in one-shot administration of the drug, in non-oxygenation of the blood in case of Mitomycin C, and in hyperthermic condition in case of Mitomycin C or TSPA. 8. Employing these technics twenty-nine patients with malignant neoplasms have been treated thirty-seven times. One axillary, two subclavian, fifteen pelvic, one iliac, seventeen femoral and one popliteal perfusions were included in this series. The follow-up period is too short to allow complete evaluation, but the results suggest that this method is one of the most impressive maneuver treating malignant neoplasms. 9. The undesirable effect either in the perfused area or systemically was practically negligible.