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KMID : 0371319660080070387
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Journal of the Korean Surgical Society
1966 Volume.8 No. 7 p.387 ~ p.406
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Cancer Chemotherapy by Continuous Intra-Arterial Infusion of Methotrexate
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張起呂/Chang, Kee Ryo
林憲命/金鍾信/李相文/吳一烋/Im, Hun Myung/Kim, Chong Sin/Lee, Sang Moon/Oh, Ill Hiew
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Abstract
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This paper reports 5 cases of various cancer patients treated by the continuous intra-arterial infusion of Methotrexate for 5 months (Nov., 1963~Mar., 1964) at Seoul National University Hospital and Pusan Gospel Hospital.
One case was maxillary cancer and 4 were liver cancer (primary 3, metastatic 1). All cases had no previous treatment. Catheter was inserted, in the case of maxillary cancer, into the left external carotid artery, and, in the case of liver cancer, into the hepatic artery through the right gastroepiploic artery or gastroduodenal artery. Methotrexate 25 mg. per 24 hours in 1,000 ml. of 5% D/W was given by arterial infusion for 3-8 days. Citrovorum Factor (C.F.) was given jntramuscularly 3 mg. every 6-8 hours(9-12 mg. per 24 hours) for 3-10 days, except in case 5.
In all cases, the size of tumor was notably reduced and the subjective symptoms slightly improved. This condition lasted for 3-5 weeks(Table 2). As the toxic effects of Methotrexate, various gastro-intestinal disturbances, such as stomatitis, nausea and diarrhea occurred in 4 cases, marked leucopenia in 3 cases, nasal bleeding with thrombocytopenia in 2 cases and chemical hepatitis in 2 cases(Table 1). Complications developed in 2 cases; clot in the catheter in 1 case, and pneumonia and cellulitis in 1 case(Table 1).
Duration of response to Methotrexate was within 5 weeks, and follow-up study revealed 3 patients expired in 5 months after treatment(Table 2).
A comprehensive review of the literature on cancer chemotherapy by continuous intra-arterial infusion of Methotrexate is presented.
(The Methotrexate, citrovorum factor and infusion assembly used in this study were generously supplied from Dr. George T. Pack, New York, U.S.A.).
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