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- W2080348770 abstract "The skill of the diagnostic radiologist in manipulating a percutaneous arterial catheter might be applied to clinical radiation therapy in a technic currently under investigation. A dose of 2,300 rads is the practical limit for radiation fields encompassing both kidneys; higher amounts lead to delayed radiation nephritis in a significant proportion of cases (1, 6). It is thought that catheterization of the renal artery with infusion of a radioprotective agent during therapy might provide protection to the kidney against radiation damage. In this way, a much higher radiation dose could be delivered to overlying tumor tissue without the risk of late radiation nephritis. Several methods have been used clinically to create or to enhance a difference in radiation sensitivity between tumor and normal tissues. Tissue oxygenation is the single most important (and the most easily altered) factor in determining local tissue radiosensitivity (2, 4). Attempts have been made to employ hyperbaric oxygen to effect a more favorable ratio between tumor and normal tissue sensitivities (3, 4). Arterial infusions of hydrogen peroxide have also been tried in an effort to raise oxygen tension locally and to increase sensitivity of tumor tissue to radiation (7). We have taken a different approach. Experimentally, we have succeeded in protecting a critical (dose-limiting) organ in radiation therapy, the normal kidney, by infusing small amounts of epinephrine selectively into the renal artery before and during radiation. Epinephrine-induced vasoconstriction causes a marked decrease in the renal blood flow and temporary renal anoxia, with a striking radioprotective effect on the canine kidney. Methods and Results The studies proceeded in four stages. First (part 1), flow measurements and blood analyses established the ability of renal artery epinephrine infusions to produce renal hypoxia. “Control” studies (part 2) next established the safety of epinephrine infusions at the required dose level and determined the local radiation dose needed to produce severe renal damage in the dog. Following this, the epinephrine infusion technic was applied experimentally to radioprotection of the kidney (part 3). Finally (part 4), a pilot clinical study was initiated, using an indwelling renal artery catheter in a patient with advanced abdominal cancer. Part 1: Physiological Studies (3 dogs)2: The animal was anesthetized with intravenous pentobarbital, the abdomen opened, and a catheter passed via the femoral artery into one renal artery. The corresponding renal vein was then sectioned, and the effluent renal vein blood conducted to a venous reservoir in order to measure its flow. From the reservoir, the blood was immediately reinfused into a femoral vein. Renal vein oxygen saturation, pH, and lactate/pyruvate ratio were also measured during a control period and then during infusion of epinephrine into the renal artery." @default.
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- W2080348770 date "1967-08-01" @default.
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- W2080348770 title "The Seldinger Catheter in Radiation Therapy" @default.
- W2080348770 doi "https://doi.org/10.1148/89.2.332" @default.
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