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An Update on the Totally Implantable Infusion Pump

Shan R. Baker, MD; Arlene A. Forastiere, MD; Richard Wheeler, MD; Barbara R. Medvec, RN

Arch Otolaryngol Head Neck Surg. 1987;113(11):1183-1190.

Abstract
• Intra-arterial chemotherapy for the treatment of localized malignant neoplasms in the head and neck is an appealing approach for several reasons. Perhaps the most important is the possibility of obtaining a regional advantage such that an increased drug concentration is delivered to the tumor site compared with that delivered systemically. The patient may, therefore, be spared systemic toxicity. We report our accumulated experience using a totally implantable infusion pump in 37 patients. A total of 42 pumps were implanted: 28 single-catheter pumps and 14 dual-catheter pumps. Radionuclide imaging demonstrated total perfusion of the tumor in all patients. A combination of cisplatin (50 to 100 mg/m²) and floxuridine (0.01 to 0.045 mg/kg/d) was used to treat 26 patients. For these heavily pretreated patients, we observed a 43% complete and partial response rate in the subgroup of patients with squamous cell carcinoma. These results are comparable with those reported for these drugs administered systemically and for other drug combinations tested in the treatment of recurrence disease.

(Arch Otolaryngol Head Neck Surg 1987;113:1183-1190)

Author Affiliations
From the Department of Otolaryngology, Head and Neck Surgery (Dr Baker), The Department of Internal Medicine, Division of Hematology/Oncology (Dr Forastiere and Ms Medvec), The University of Michigan Hospitals, Ann Arbor, and the Comprehensive Cancer Center, University of Alabama at Birmingham (Dr Wheeler).

Footnotes
Accepted for publication June 17, 1987.

Read before the American Society for Head and Neck Surgery, Denver, April 30, 1987.

Reprint requests to Department of Otolaryngology Head and Neck Surgery, TC 1904, Box 312, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0312 (Dr Baker).

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