[Intra-arterial chemotherapy in locally advanced or recurrent breast neoplasms]. / La chemioterapia intraarteriosa nella neoplasia mammaria localmente avanzata o recidiva.

Intraarterial chemotherapy is studied as an alternative procedure for the neoadjuvant treatment of locally advanced and recurrent breast cancer. Our study was aimed at investigating the feasibility, the toxicity and the local response rate of an intraarterial chemotherapy regimen including 5-fluorouracil, epirubicin and mitomycin. These drugs were administered angiographically into the subclavian and internal mammary arteries ipsilateral to the lesion. We treated 20 women with a median age of 58 years (range: 42-74 years); 12 patients had locally advanced breast cancer with a median tumor size of 12 cm (range: 6-20 cm) and 8 patients exhibited cutaneous, thoracic or axillary recurrences, with a median lesion size of 6 cm (range: 3-12 cm). In all, we administered 54 cycles of chemotherapy drugs (mean: 2.7 cycles a patient). Most patients were submitted to selective catheterization of the internal mammary artery (44/54 cycles); all the drugs were injected into the subclavian artery only when catheterization of this vessel was unfeasible. No angiography-related toxicity was observed. No systemic, particularly hematological, toxicity was observed. Four patients exhibited skin erythema in the feeding region of the internal mammary artery, 2 hemialopecia, 1 cutaneous steatonecrosis and 1 transient hemiplegia. We obtained 1 complete remission and 11 partial responses, with 60% overall response rate (12/20 patients). All the patients with locally advanced breast cancer had an objective response and the mean interval between the start of therapy and radical mastectomy was only 49 days. In conclusion, intraarterial chemotherapy for locally advanced or recurrent breast cancer is a feasible and well-tolerated tool which needs further studies, particularly to assess its efficacy.

Brain penetration of intrathecal iomeprol in dogs.

PURPOSE: Iomeprol, a new nonionic iodinated compound for intravascular use, is being evaluated as a myelographic contrast agent because of its low neurotoxicity. This study aimed to assess the degree of brain penetration of iomeprol after intrathecal administration. MATERIAL AND METHODS: Brain penetration in dogs was investigated by CT and compared with that of iopamidol, iohexol, and ioversol, currently used as myelographic contrast media (CM). Nervous tissue density was determined in different brain structures by recording Hounsfield values. RESULTS: The experiments revealed that CM diffused from the cisternae into the parenchyma, reaching a maximum at 5-24 h after injection. The density of the examined brain regions was still higher than the preinjection levels 24 h later. No differences in brain penetration were observed among the CM investigated. CONCLUSION: The study has shown that iomeprol penetrates into the brain to the same extent as the most widely used myelographic CM.