A new technique for hepatic infusional chemotherapy

Constant-infusion intra-arterial chemotherapy is associated with a significantly greater tumor response rate and perhaps an improved survival rate. Many intra-arterial drug delivery systems have been described, the most popular of which is the implanted Infusaid pump. Unfortunately, this is an expensive device that requires considerable experience in its implantation and maintenance. This paper describes a simplified, inexpensive technique, which can comfortably and reliably provide intra-arterial hepatic chemotherapy to patients treated in most moderate-size community hospitals. Implantation requires angiography and a minor surgical procedure. Maintenance of the system is easy and inexpensive. While use of the Infusaid pump is preferable, this technique is a reasonable alternative for the following: 1) patients with very poor hepatic function, 2) patients who cannot afford the implanted pump, 3) patients who have concomitant extrahepatic tumor, 4) patients with noncolorectal metastasis to the liver, and 5) patients treated at hospitals that do not have implanted pump capabilities.