[Interventional DSA in lung cancer--bronchial artery infusion]

Bronchial artery infusion (BAI) has been looked to as an important adjunct for controlling lung cancer. However, there are some anatomic facts to meet in performing angiography: multiplicity of the bronchial artery with wide variation of ramification pattern. To deal with these problems, since 1984, we have been working with DSA apparatus (Siemens: ANGIOTRON) for intervention in 162 cases of lung cancer. Because of higher contrast resolution, subtracted dynamic image and realtime replay on CRT, DSA allows (1) bronchial artery mapping on aortography, (2) prompt verification of the areas to be or not to be infused by anticancer drugs, and (3) tumor stain not only in the primary lesion but also metastasized lymph nodes or mediastinal invasion. DSA aortography evaluated the right-sided bronchial artery more frequently (90.1%) than the left-sided (46.3%). Tumor location made feeding vessels more remarkable on DSA: 96.0% in the right and 68.9% in the left. The overall accuracy of BAI basically depends on the result of DSA measuring 91.9% (149 of 162 cases). The effect of BAI combined with radiation therapy, for each histologic category, preliminarily estimated in two groups: one with two drugs and another with CDDP. Small cell carcinoma with "two drugs" and squamous cell carcinoma with CDDP seem to show statistical predominance in the period of 50% tumor size reduction.