Intra-arterial infusion therapy for pulmonary tumours

On a total of 47 patients with pulmonary tumours (45 carcinomas and two pulmonary sarcomas) intra-arterial infusion therapy was performed via the bronchial artery (34 cases), the pulmonary artery (11 cases), the internal thoracic artery (1 case) and the intercostal artery (1 case). Cytostatic drugs were given to 43 patients (mainly in the form of single-drug therapy) and four patients received a preparation of proteolytic enzymes. In the majority of cases (34 of 47 patients) intra-arterial therapy was followed by intravenous cytostatic treatment. We can evaluate the effect of the intra-arterial therapy on the basis of the number and extent of tumour remissions, as well as of acute or subacute side effects. Effects over longer period and the survival times of patients can only be evaluated to a limited extent. We observed one complete tumour remission, five partial remissions (size of tumour reduced by more than 50%) and eight minor remissions (reduction by less than 50%); in 18 cases there was no measurable change in the tumour and in nine cases progression was observed (six cases cannot be evaluated.) Complete or partial remissions were observed only after treatment via the bronchial artery and after cytostatic therapy. These tumours were rather poorly vascularised and remissions occurred irrespective of cell type. There are certain indications that intra-arterial chemotherapy may be superior to equivalent intravenous chemotherapy, but the evidence so far available is not conclusive.