Lutz R J, Epstein A H, Cook J A, Dedrick R L
Biomedical Engineering and Instrumentation Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892-5766, USA.
Gynecol Oncol. 1995 Nov;59(2):288-96. doi: 10.1006/gyno.1995.0024.
Regional delivery of suitable drugs by intra-arterial infusion may offer a therapeutic advantage. High concentrations in the tumor are sought with reduced systemic toxicity. Adequate mixing of drug solutions with perfusing blood is essential to provide uniform distribution of drug to tumor-bearing tissue distal to the infusion site. Using a glass model of the iliofemoral and pelvic arteries, we have demonstrated that a streaming phenomenon occurs. Laminar "streamers" of slowly infused drug solution originate at the catheter tip and proceed nonuniformly into distal arterial branches. The intensity of streaming and the pattern of distribution are highly sensitive to catheter tip placement and quite unpredictable. The consequence of regional therapy under streaming conditions is severe maldistribution of drug in the infused tissues with potentially high levels delivered to normal tissues and simultaneous subtherapeutic levels delivered to tumor. Our in vitro model can be used to test appropriate infusion techniques that enhance mixing such as pulsed infusions and novel catheter designs.
通过动脉内输注进行合适药物的区域给药可能具有治疗优势。旨在在肿瘤中达到高浓度，同时降低全身毒性。药物溶液与灌注血液充分混合对于将药物均匀分布到输注部位远端的肿瘤组织至关重要。使用髂股动脉和盆腔动脉的玻璃模型，我们已经证明会出现一种流注现象。缓慢输注的药物溶液的层流“流束”起源于导管尖端，并不均匀地进入远端动脉分支。流注强度和分布模式对导管尖端位置高度敏感且相当不可预测。在流注条件下进行区域治疗的结果是药物在输注组织中严重分布不均，可能会有高水平的药物输送到正常组织，同时肿瘤组织接受的治疗水平不足。我们的体外模型可用于测试合适的输注技术，如脉冲输注和新型导管设计，以增强混合效果。
