Development of a new arterial infusion chemotherapy for locally advanced breast cancer

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1 167 Vol. 37, pp , 2009 Development of a new arterial infusion chemotherapy for locally advanced breast cancer : Interventional radiology IVR IVR IVR Oncology IVR Transarterial infusion chemotherapy TAI 1mm TAI Quality of life QOL 5cm T3 T4 N2 91

UV»¼ 168 W X E Fig. 2 Arterial infusion using a blood pressure cu# &%i&- Aῌ 2 NOP j ST+U+' (k @ l )m -no ;pq* 5 ῌ `ak NBCA -+,r&'st, Fig. 1 3D-CT during Left ventriculography 1.

/ xy z{ 05 &' NOP 1 I 4 23 ῌ Y= NOP 1 ῌ 70ῐῒ90ῐ 2ῒ9 ῌ &' ( Neoadjuvant therapy % E #5j 6! ; ῌ ST+U+ {9:;P < = & >?+ e 9:! " -I,r&%-78 0 4 @ 3 ῌFig. 2 ῌ NBCA 7A S +, ῌLipio- $ % )*+*,-./0-12 34 5 6!

2 UV»¼ 168 W X E Fig. 2 Arterial infusion using a blood pressure cu# &%i&- Aῌ 2 NOP j ST+U+' l )m -no ;pq* 5 ῌ àk NBCA -+,r&'st, Fig. 1 3D-CT during Left ventriculography 1. Internal thoracic artery, 2. Lateral thoracic artery, 3. The other branches from axillary arteries, 4. Intercostal artery, 5. Superior and inferior epigastric arteries uv à5 4L ῌ w -. / xy z{ 05 &' NOP 1 I 4 23 ῌ Y= NOP 1 ῌ 70ῐῒ90ῐ 2ῒ9 ῌ &' ( Neoadjuvant therapy % E #5j 6! ; ῌ ST+U+ {9:;P < = & >?+ e 9:! " -I,r&% ῌFig. 2 ῌ NBCA 7A S +, ῌLipio- $ % )*+*,-./ ! 59: ; - E 4} ~ E B / down staging -; 5 dol: LPD, *, + 78 E BC 8p 5 ῌ < 8 B _ ῌNBCA-LPD -+ ῌ =4ῌ > Fig. 1?5@A 9 B / 1 % *+ + f d PU )*+*, EF &' I J E &' C D ῌ ( 10ῒ13 E'(+)*+*, G 3.3Fr G 5Fr Hs - ) - A GH ῌ *+*, I NOP day 1,, NOP ST+U+ G (, e +e Hs * ;P <L '(6 J E -K 5 4L ME NOP E -Q 5R4 ῌ sª«40 mg ῑ body ῌ T+ day FU750 mgῑbody ῌ K ῌRedistributed subclavian arterial infusion ±e chemotherapy: RESAIC -VW 4 ῌ D d 5 ῌ X Y Z! [ 2 " ῌ 1 N+-OP > ¹Qº-VR &' day1,, 14 :\] ^4 % -_#` a$b cdefgs, ῌN-butyl cyanoacrylate: NBCA, B-Braun, Germany à 5 10 mgῑday ῌ T+ -²72 ³+ -T 5 3h 92 + µ Ll +M S3 5FU ±e ῌ

169 RESAIC 2 70 RESAIC 2006 4 2009 3 22 20 597 2 20 12 8 7 7 1 RESAIC 11 5 4 a RESAIC 100 2222 CTCAE Common

0 55815 RE- CIST Response Evaluation Criteria in Solid Tumors 4 CR 12 PR 4 SD CRPR 80 1620 CRPRSD 100 2020 SD 1 1 CR

3 169 RESAIC 2 70 RESAIC RESAIC a RESAIC CTCAE Common Terminology Criteria for Adverse Events ver3.0 grade1 2 grade2 6 grade3 1 grade4 4 grade RE- CIST Response Evaluation Criteria in Solid Tumors 4 CR 12 PR 4 SD CRPR CRPRSD SD 1 1 CR 4 3 b Fig. 3 a: Before therapy, b: Six month later 1 Fig RESAIC 6 7 pathological CR 536 tumor free 2 Fig RESAIC

recurrent breast cancer. Am J Clin Oncol 24: 185191.

4 170 NBCA a b Fig. 4 a: Before therapy, b: 4 month later RESAIC QOL Murakami M, et al 2001 Intraarterial infusion chemotherapy and radiotherapy with or without surgery for patients with locally advanced or recurrent breast cancer. Am J Clin Oncol 24: Kitagawa K, et al 2002 Preoperative transcatheter arterial infusion chemotherapy for locally advanced breast cancer stage IIIb for down-staging and increase of resectability. Eur J Radiol 43: Fiorentini G, et al 2003 First-line intraarterial chemotherapy IAC with epirubicin and mitoxantrone in locally advanced breast cancer. Anticancer Res 23: Koyama H, et al 1975 Intra-arterial infusion chemotherapy as preoperative treatment of locally advanced breast cancer. Cancer 36: Stephens FO 1990 Intraarterial induction chemotherapy in locally advanced stage III breast cancer. Cancer 66: Görich J, et al 1995 Previously treated, locally recurrent breast cancer: treatment with superselective intraarterial chemotherapy. Radiology 197: Bufill JA, et al 1994 Intra-arterial chemotherapy for palliation of fungating breast cancer. A case report and review of the literature. Am J Clin Oncol 17: Pacetti P, et al 2006 Intra-arterial chemotherapy: a safe treatment for elderly patients with locally advanced breast cancer. In Vivo 20: Clouse ME, et al 1977 Complication of long 94

5 171 term transbrachial hepatic arterial infusion chemotherapy. Am J Roentgenol 129: Arai Y, et al 1990 A study of technical problems in hepatic arterial infusion chemotherapy using percutaneous approach. Jpn J Med Imaging 9: Takeuchi Y, et al 1996 A new percutaneous catheterization side holed catheter placement with fixation for a long term arterial chemotherapeutic infusion: its e#ectiveness to prevent hepatic arterial occlusion. Intervent Radiol 11: Seki H, et al 1999 Hepatic arterial infusion chemotherapy using percutaneous catheter placement with an implantable port: assessment of factors a#ecting patency of the hepatic artery. Clin Radiol 54: Takizawa K, et al, Development of a new subclavian arterial infusion chemotherapy method for locally or recurrent advanced breast cancer using an implanted catheter-port system after redistribution of arterial tumor supply. Cardiovasc Intervent Radiol published online 24 February

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