title: Flexibility and efficacy of automatic continuous fluorodeoxyuridine infusion in metastases from a renal cell carcinoma.
abstract: Complete and lasting control of diffuse metastases from a renal cell carcinoma has been achieved by automatic continuous infusion of a single cytotoxic agent, fluorodeoxyuridine (FUDR). A patient with a single brain metastasis from renal cell carcinoma developed pulmonary, mediastinal, and retroperitoneal metastases after radical nephrectomy. A Medtronic Synchromed pump (Medtronic Inc., Minneapolis, MN) was implanted for the circadian systemic infusion of FUDR in 14-day courses with 14-day drug-free intervals. A complete response (CR) at all sites, was obtained in 3 months, and maintained for 22 months. After a second brain metastasis, treated by radiation therapy and cisplatin as radiosensitizer, a CR was obtained again and is now of 31 months' duration, which is four times the record to date. The overall hospitalization was 2 days. Acceptance of the pump is excellent and it functions precisely and reliably. This case should stimulate greater interest in techniques of automatic continuous infusion of cytostatics, given its greater efficacy and lower toxicity.
authors.affiliation: Servizio di Radiologia, Istituto Nazionale Tumori, Milano, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Damascelli
authors.forename: A
authors.initials: A
authors.lastname: Marchianò
authors.forename: L F
authors.initials: LF
authors.lastname: Frigerio
authors.forename: M
authors.initials: M
authors.lastname: Salvetti
authors.forename: C
authors.initials: C
authors.lastname: Spreafico
authors.forename: F
authors.initials: F
authors.lastname: Garbagnati
authors.forename: F
authors.initials: F
authors.lastname: Zanoni
authors.forename: F
authors.initials: F
authors.lastname: Radice
mesh_terms: D001932:Brain Neoplasms / Q000188:drug therapy / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000556:secondary; D002940:Circadian Rhythm; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005467:Floxuridine / Q000008:administration & dosage*; D006801:Humans; D015918:Infusion Pumps, Implantable; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged
chemical_list: D005467:Floxuridine