Chemoembolization with carboplatin of the lung. Feasibility and toxicity in a pig model.

Abstract

OBJECTIVES: Chemoembolization of the lung was evaluated as a novel treatment for unresectable lung metastases. Based on our encouraging results in a rodent model (rat), the aim was to prove the safety and effectiveness of this novel method in a large animal model before clinical application of this therapy. MATERIALS AND METHODS: Eight pigs underwent femoral vein puncture. The tumor-supplying pulmonary arteries were selectively explored and chemoembolization with degradable starch microspheres (DSM) and carboplatin was administered. Survival, hemodynamic parameters, ventilation gas exchange, digital subtraction angiography (DSA) and pulmonary X-rays were documented during and after chemoembolization. As a follow-up, a pulmonary X-ray was assessed every week for six months after chemoembolization when the animals were sacrificed and the lungs histologically examined. RESULTS: Selective and reversible chemoembolization of the right lung was recorded by DSA. Only slight hemodynamic effects were seen during selective chemoembolization of the lung. X-ray examinations showed no early or late abnormalities. The histological examination of the lung tissue six months after chemoembolization showed that the parenchyma was normal. CONCLUSION: This is the first study of chemoembolization of the lung in a large animal model. The feasibility, mild hemodynamic acute effects and the absence of long-term toxicity were documented. These observations justify patient studies in unresectable lung metastases.