Angiographic contributions to the management of advanced cancer

Angiography has proved to be a useful adjuvant to management of advanced cancer. By arterial infusion, greater tumor response to drugs may be achieved than by systemic administration. In osteosarcomas, improved control of primary tumors by intraarterial drug therapy (n = 53) permitted more frequent limb salvage procedures, and, in advanced bladder cancer (n = 18), pain and hematuria were controlled in the majority. Some brain tumors (n = 30), failing control by other methods, have responded to intraarterial chemotherapy. Arterial embolization is also useful for tumor control in combination with surgery and chemotherapy. In unresectable giant cell tumors of bone and aneurysmal bone cyst, pain relief and tumor regression occurred in over half the patients. In hepatic tumors, failing control by intraarterial drug infusion, embolization of the tumor extended survival. A brief description of new methods for intravascular delivery of chemotherapeutic drugs completes this overview of experience at M.D. Anderson Hospital with angiographic cancer therapy.