Section I - Rationale and Technical Aspects.- 1. Introduction to the Concept and Practice of Infusion Chemotherapy.- Categories of Infusion Chemotherapy.- Rationale for Systemic Infusional Chemotherapy.- Technologic Impetus to Infusional Chemotherapy.- Current Clinical Status of Infusional Chemotherapy.- Summary.- 2. Experimental Rationale for Continuous Infusion Chemotherapy.- Antimetabolites.- Plant Alkaloids.- Alkylating Agents.- Antineoplastic Antibiotics.- Miscellaneous Agents.- Summary.- 3. The Clinical Pharmacology of Infusional Chemotherapy.- Pharmacokinetics of Infusional Therapy.- Regional Therapy.- 4. Drug Administration Systems for Infusion Chemotherapy.- Patient Worn Extracorporal Systems.- Implantable Infusion Systems.- Alarms and Performance Status Information.- 5. Technical Aspects of Vascular Access for Infusional Chemotherapy.- Introduction-Venous Access.- Arterial Access.- Summary.- 6. Nursing Management of Infusion Catheters.- Hickman Catheters.- Subclavian Catheters.- Implantable Venous Access Portals.- Special Considerations.- Management of Local Skin Effects.- Complications Associated with Subclavian Catheters.- Detection and Management of Infection.- Hepatic Artery Catheters.- Implantable Infusion Pump.- Pump Complications.- Conclusion.- 7. Pharmaceutical Issues in Infusion Chemotherapy Stability and Compatibility.- Concepts and Definitions.- Procedures for Study of Stability.- Short-Term Stability.- Long-Term Stability.- Admixtures.- Conclusion.- Section II - Chemotherapeutic Agents.- 8. Antipyrimidines: 5-Fluorouracil and 5-Fluoro-2?-Deoxyuridine.- Clinical Trials of Fluorinated Pyrimidines Given by Short- and Long-Term Intravenous Infusions.- Studies of Protracted Venous Infusion of the Fluorinated Pyrimidines.- 9. Mexthotrexate.- Theoretical Considerations.- Clinical Investigations.- Summary.- 10. Anthracyclines.- General Considerations.- Methods of Doxorubicin Infusion.- Therapeutic Implications of Continuous Venous Infusion of Doxorubicin.- Anthracycline Analogues.- 11. Cisplatin, Platinum Analogues, and Other Heavy Metal Complexes.- Cisplatin.- Intra-Arterial Cisplatin.- Platinum Analogues.- Gallium Nitrate (Ga(NO3)3).- Spirogermanium.- 12. Cytosine Arabinoside.- Background.- Clinical Research.- 13. Periwinkle Alkaloids I: Vinblastine and Vindesine.- Background.- Rationale for Infusion.- Vinblastine (Phase 1 Trials).- Vinblastine (Phase 2 Trials).- Vindesine (Phase 1 Trials).- Vindesine (Phase 2 Trials).- Conclusions.- 14. Periwinkle Alkaloids II: Vincristine.- Clinical Trials.- Results.- Discussion.- 15. Bleomycin.- Mechanism of Action.- Pharmacology.- Bleomycin Toxicology.- Animal Studies.- Pharmaceutical Data.- Clinical Trials in Humans.- Testicular Cancer.- Head and Neck Cancer.- Cervical Cancer.- Lymphomas.- Other Tumors.- Discussion.- 16. The Epipodophyllotoxins: VP-16 and VM-26.- Mechanism of Action.- Clinical Pharmacology.- Schedule Dependency.- Pharmaceutical Data.- Clinical Trials.- Discussion.- 17. Alkylating Drugs and Other Agents.- Alkylating Agents.- Antimetabolites.- Miscellaneous Cytotoxic Agents.- Summary.- 18. Investigational Agents.- 19. Protracted Infusional Chemotherapy.- Preclinical Pharmaceutical Studies.- Phase 1 Studies.- Summary of Phase 1 Trials of Protracted Infusion Chemotherapy.- Phase 2 Studies.- Phase 3 Trials.- Section III - Systemic Infusion by Tumor Category.- 20. Head and Neck Cancer.- Background.- Rationale of Infusion Chemotherapy.- Clinical Trials.- Summary.- 21. Esophageal and Anal Cancer.- Preoperative Versus Postoperative Therapeutic Concepts.- Anal Canal Tumors.- Squamous Cell Cancer of the Esophagus.- Present and Future Status of Anal and Esophageal Cancer Therapy.- 22. Colorectal Cancer.- Standard Bolus 5-Fluorouracil.- 5-Fluorouracil and FUDR Continuous Infusion.- Other Agents.- Infusional 5-FU Concomitant with Radiation.- Adjuvant Infusional Chemotherapy.- Summary.- 23. Gastric, Pancreas, and Biliary Tract Cancer.- Conventional Treatment.- Chemotherapy by Infusion for Stomach, Pancreas, and Biliary Tract Carcinoma.- Intra-Arterial Therapy.- Discussion.- 24. Breast Cancer.- Infusion Studies of Doxorubicin.- Continuous Infusion of Vinca Alkaloids.- Continuous Venous Infusion Trials with Other Drugs.- 25. Infusion for Hematologic Malignancies.- Vinca Alkaloids.- Epipodophyllotoxins.- Antibiotics.- Alkylating Agents.- Antimetabolites.- Metals.- New Drugs.- Combination Chemotherapy.- Conclusions.- 26. Lung Cancer.- Theory and Background.- Modalities of Administration of DDP-BLM and Associated Drugs.- Modalities of Administration of 1 or 2 Complementary Drugs.- Secondary Therapy Protocols in Relation to Clinical Situations.- Results.- Discussion.- Other Trials of Infusion Chemotherapy.- Summary.- 27. Testicular Cancer and Other Tumors of the Male Genitourinary Tract.- Vinblastine and Bleomycin Combination in the Management of Germ Cell Tumors.- Prostatic Carcinoma.- Urothelial Tumors.- 28. Gynecologic Malignancy.- Cancer of the Cervix.- Ovarian Cancer.- Other Sites.- Conclusion.- 29. Soft Tissue and Osteogenic Sarcomas.- Standard Bolus Chemotherapy.- Regional Infusion Chemotherapy.- Systemic Infusional Chemotherapy.- Combined Modality Therapy.- Summary and Conclusions.- 30. Uncommon Tumors.- Malignant Melanoma.- Hepatocellular Carcinoma.- Apudomas.- Thymoma.- Summary and Commentary.- Section IV-Regional Infusion.- 31. Head and Neck Cancer.- Regional Infusion: Background and Experience.- Limitations and Complications of Regional Infusion.- Use of External and Implantable Pumps.- Summary.- 32. Regional Infusion for Metastatic Liver Tumors.- Incidence and Natural History of Metastatic Liver Tumors.- Rationale and Methodology of Infusion Chemotherapy via Hepatic Artery.- Therapeutic Results of Hepatic Arterial Infusion Chemotherapy.- Hepatic Artery Ligation (HAL) and Arterial Infusion Chemotherapy.- Portal Vein Infusion Chemotherapy.- Transcatheter Embolization and Arterial Infusion Chemotherapy.- Summary and Conclusions.- 33. Hepatic Arterial Infusion Chemotherapy: Clinical Trials with the Implantable Pump.- Nonrandomized Clinical Trials.- Prospective Randomized Controlled Trials.- National Cancer Institute Trial.- Summary.- 34. Regional Infusion for Primary Hepatic Carcinomas.- The UAB Experience with Regional Adriamycin Chemotherapy for Hepatoma Patients.- Experience at M.D. Anderson Hospital and Tumor Institute.- Summary.- 35. Hepatic Artery Ligation and Portal Vein Infusion.- Effects of Hepatic Artery Ligation on Liver Parenchyma.- Effects of Hepatic Artery Ligation on Liver Metastases.- Effects of Portal Infusion on Liver Metastases.- Effect of HAL and Portal Infusion on Liver Metastases.- Conclusion.- Section V-Special Categories of Infusion Chemotherapy.- 36. Regional Infusion for Brain Tumors.- Clinical Experience.- Review of the Literature.- 37. The Clinical Use of 5-Fluorouracil and Other Halopyrimidines as Radiosensitizers in Man.- Preclinical Studies.- Pharmacology of Infused 5-FU.- Clinical Studies of 5-FU Radiosensitization.- Current Clinical Status of Infused 5-FU and X-rays.- Current Clinical Status of BUDR and IUDR.- Conclusions.- 38. Intraperitoneal “Belly Bath” Chemotherapy.- Intracavitary Sclerosing Therapy.- Pharmacokinetic Rationale for Intraperitoneal Chemotherapy.- Acute and Chronic Toxicities of Intraperitoneal Chemotherapy.- Trials of Single-Agent Intraperitoneal Chemotherapy.- Combination Intraperitoneal Chemotherapy.- Conclusion.- 39. Intraventricular Chemotherapy for Leptomeningeal Carcinoma.- Clinical Presentation of Carcinomatous Meningitis.- ‘Concentration x Time’ Therapy in Carcinomatous Meningitis.- Drug Delivery System.- Drug Administration and Toxicity.- Clinical Management.- Clinical Experience.- Case Presentations.- Conclusions.- 40. Intravesical Chemotherapy for Bladder Tumors.- Characteristics of Superficial Bladder Cancer.- Clinical Presentation and Diagnosis.- Staging and Classification.- Mechanisms of Recurrence.- Risk Factors for Recurrence and Progression of Superficial Bladder Cancer.- Agents for Intravesical Therapy.- Comparative Studies.- 41. Combination Chemotherapy and Infusional Schedules.- Tactics of Combination Chemotherapy.- Combination Chemotherapy with Single-Agent Infusions.- Combination Chemotherapy Using Drug Admixtures.- Summary.- 42. Continuous Infusion Antibiotic Therapy for Neutropenic Patients.- Infection in Neutropenic Patients.- In Vitro Studies.- Experimental Animal Studies.- Human Pharmacology Studies.- Clinical Therapeutic Studies.- 43. Degradable Starch Microspheres Infusion: Basic Considerations for Treatment of Hepatic Neoplasia.- Choice of Tracer for Continuous Monitoring of DSM Treatment.- Monitor for Continuous Registration of the Effect of DSM on the Passage of Low-Molecular-Weight Substances.- Effect of DSM on the Passage of Low-Molecular-Weight Substances in the Treatment of Liver Tumors.- Effect of Portal Blood Flow in the Passage of 99mTc-MDP Injected Intra-Arterially with DSM.- Importance of AV Shunting to the Effect of DSM.- Kinetics of the Passage of 99mTc-MDP Injected with DSM.- Conclusion.- 44. Cost-Effectiveness in Cancer Chemotherapy.- Defining the Cost Basis.- Comparative Costs of Infusion Chemotherapy.- Cost Comparisons: Bolus Versus Infusion Chemotherapy.- Summary.- 45. Adjuvant Applications of Infusional Chemotherapy.- Colon and Rectal Cancer.- Applications of Adjuvant Infusional Chemotherapy to Other Tumors.- Protochemotherapy.- Summary.- References.