When patients are treated with general chemotherapy, chemo medicine will naturally spread throughout the body. Unfortunately, the drug distribution is not limited to only cancerous areas, but healthy areas as well. For this reason, general chemo has strong side effects, and is not particularly successful as a therapy. Therefore, we promote transarterial chemo-injection instead of systemic chemotherapy. In this procedure, we insert a catheter and give chemo medicine through the artery that supplies blood to the cancerous area. The advantage is a big increase in drug density inside cancer within a short period of time. The disadvantage is that the high drug density inside cancer is difficult to maintain, because the chemo medicine will eventually spread to the rest of the body quickly via the bloodstream. However, in this procedure, the side effects are less than the effects associated with systemic chemotherapy. At Fuda, we are researching whether there is an effective way to keep the chemo medicine staying at the cancer site as long as possible, instead of spreading to the whole body, which may cause the many side effects.
Cancer Microvessel Intervention (CMI) combines different chemo medicines into a fine grain particle. By using superselective catheterization, this fine grain particle will be distributed inside the artery which supplies the target cancer. The fine grain particle of chemo medicine will stay inside tumor tissue and maintain a high density for a long period of time. CMI is based on the following theory: there are a lot of gaps among the cancer capillary endothelial cells, and tight junctions among the normal capillary endothelial cells. The fine grain chemo particle will go inside the interstitial space of cancer tissue, which causes an increase in osmotic stress, selectively constricts the cancer micro-capillary, and then blocks the blood flow. Therefore, the fine grain particle will stay inside the tumor for a relatively long time. Meanwhile, because of its small size, there will not be embolism (blockage) in the normal capillary. Because we are able to use less chemo medicine, the side effects on the entire body are much less than those of systemic chemotherapy.
Advantages of CMI
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We compare the CMI with the general chemo for whole body. There is an example to help you understand the advantages of CMI. If a patient weights 60kg and the tumor weights 50g(0.05kg).
| General chemo by vein infusion |
If we give 150mg Oxaliplatin by vein infusion, there is only 0.125mg Oxaliplatin inside the tumor; the other 149.875mg will flow to other organs of body. |
| Cancer Microvessel Intervention(CMI) |
Just 15mg Oxaliplatin by superselective catheterization and intervention. For example, two thirds (10mg) of the Oxaliplatin has been distributed throughout the body via blood circulation; one third (5mg) of that remains in the targeted tumor tissue. The amount of chemo medicine remaining inside tumor is 40 times greater than with general chemo vein infusion. (5mg=0.125mg X 40).
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The effect of CMI is much better than general chemo via vein infusion.This is the advantage of CMI.
Process of manufacturing the chemo medicine into a fine grain particle
Clinical Cases of CMI
Clinical case 1 ：Tongue Cancer（right）
A: Tumor stain can be seen in most part of the tumor via angiography of super-selective intubation in right artery of tongue
B: Most of the stain has disappeared after CMI (the great vessels have been kept, not embolized)
For patient: Dehydration and Reduction of the Tumor
Clinical case 2：Multiple vertebral metastases from breast cancer
Clinical case 3 ：Right lung cancer
A: No activity of metastasis in the right lung by PET
B: The seeds inside of focus by CT
C: After receiving cryosurgery and seed implantation, the activity of metastasis intra lung has been completely controlled by PET, but around the central necrosis the metastasis is still active
D: Most of the tumor stain disappeared after CMI treatment
>Clinical case 4： Thyroid cancer
A: Two sphere tumor stain in left superior thyroid artery by DSA
B: The tumor stain disappeared after CMI treatment
Multiple tumor stains in left thyrocervical trunk ；The tumor stain disappeared immediately via CMI treatment.
C: Comprehensive tumor stain in right arteriae thoracica interna by DSA
D: The tumor stain disappeared via CMI treatment
E, F: 3 hours after treatment, the lump became softer and smaller;
G.H: 3 days after treatment, the lump became even softer and smaller, and the skin tension became better
Due to breast cancer, the skin nearby became hard, and the color became crineus.
K: Angiography image of the left chest's superficial artery
L: Tumor blood vessel and stain lessened after CMI treatment
2 days after CMI treatment: skin tension lessened and the skin became rosy, indicating that the tension inside the tumor was lessened
Clinical case 5：
Metastasis to left cervical part, inferior extremity cervical vertebra, and superior extremity vertebra thoracalis
Tumor stains disappeared after the CMI treatment
Tumor stains disappeared after the CMI treatment
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