J. A. Goldberg

C. S. McArdle10
N. Willmott6
D. J. Kerr6
J. H. McKillop6
R. G. Bessent3
10C. S. McArdle
6N. Willmott
6D. J. Kerr
6J. H. McKillop
3R. G. Bessent
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Many colorectal liver metastases are hypovascular, and their low level of perfusion is associated with limited drug uptake and poor response rates with regional chemotherapy. We have previously shown that hepatic arterial vasoconstrictors may increase drug delivery to liver tumours, but the underlying haemodynamic changes have not been defined. Using(More)
Cytotoxic microspheres have been developed for intra-arterial use in patients with liver metastases. Following injection, the distribution of microspheres reflects the pattern of hepatic arterial blood-flow. Vasoactive agents, such as angiotensin II, by producing vasoconstriction in normal liver, might divert arterial blood toward tumour and thereby enhance(More)
Regional chemotherapy is commonly used to treat patients with colorectal liver metastases. However, improvement in survival has still not been demonstrated. Cytotoxic loaded albumin microspheres for arterial administration have been described as a means of improving the the therapeutic index, but their distribution depends upon the prevailing pattern of(More)
By measuring peripheral drug levels in plasma, the effect of combining albumin microspheres with angiotensin II on systemic exposure to 5FU when administered by bolus injection into the hepatic artery in patients with advanced colorectal liver metastases has been assessed. The results suggest that despite hepatic arterial administration of 5FU, there was no(More)
The outlook for patients with colorectal liver metastases is poor. Microspheres have been combined with cytotoxics and administered via the hepatic artery in an attempt to improve tumour drug exposure within the liver. However, it has been suggested that arteriovenous connections might occur in association with intrahepatic tumours causing loss of regional(More)
Conventional imaging techniques are of limited value in identifying small liver metastases. Indirect methods of measuring blood-flow have shown that metastases may be associated with subtle changes in liver blood-flow. Doppler ultrasonography has the ability to measure liver blood-flow directly. In this study, the role of duplex sonography in the detection(More)
The pharmacokinetics of 5-fluorouracil (5FU) following its administration via the hepatic artery in conjunction with biodegradable albumin microspheres and angiotensin II have been studied. Peripheral venous concentrations of 5FU are lower and plasma clearance values higher following intrahepatic arterial administration compared with a similar dose(More)
Angiotensin II (AT-II) has been used to target regionally-administered cytotoxic microspheres in patients with intrahepatic tumours. The optimisation of vasoconstrictor targeting requires a knowledge of the blood flow changes induced by agents such as AT-II. We therefore assessed duplex/colour Doppler sonography (DCDS) as a means of evaluating the effects(More)
The results of systemic chemotherapy for treatment of many of the solid tumours are poor. Regional chemotherapy is an attractive concept which aims to improve tumour drug exposure and reduce systemic toxicity by delivering the cytotoxic in concentrated from directly to the tumour-bearing organ. via its arterial supply. In the absence of new agents with(More)
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