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Example text
Concerning 52 Hänninen and Denecke gastric exposure, proton pump inhibitor therapy is being recommended as ulcer prophylaxis. In all cases, a careful evaluation of the risk/benefit ratio has to be performed before treatment initiation and during radiation planning. 4. Clinical Outcome Image-guided local tumor ablation has been established as a valuable adjunct in oncological treatment concepts. Most locally ablative procedures are performed by applying thermal ablation, such as radiofrequency or laser.
Thus, liver exposure to arterially infused drugs should be reduced during retrograde perfusion. An experimental study using a rat model for colorectal liver tumors indeed showed that melphalan content in tumor tissue was unaffected by retrograde IHP, but liver uptake was reduced by 80% (17). These results suggest that retrograde liver perfusion may decrease hepatotoxicity while maintaining antitumor efficacy. As mentioned before, several drugs have been applied in IHP including 5-FU, mitomycin C, cisplatin, and melphalan, but in the past 10 yr melphalan has been the only drug used in major clinical studies (10).
16). Regarding the small and large bowel, dose thresholds have not been estimated yet, but it has been hypothesized that they are similar to those described for the gastric wall. Overall, however, these complications and late effects are rare (5,17). Concerning 52 Hänninen and Denecke gastric exposure, proton pump inhibitor therapy is being recommended as ulcer prophylaxis. In all cases, a careful evaluation of the risk/benefit ratio has to be performed before treatment initiation and during radiation planning.
