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Seven patients with advanced gallbladder carcinoma were given intraarterial infusions of 10 to 15 mg mitomycin C with 10 to 24 days' interval, 3 received intravenous infusion (10 mg/m2) with median 3 weeks' interval. Stationary disease was obtained in 4 patients, progressive disease in 4, and treatment failures in 2. The median survival after mitomycin C treatment was 4 months (range 1-23 +). Irreversible thrombocytopenia occurred in 2 patients and a severe gastrointestinal bleeding episode in one.

Short-term intra-arterial Mitomycin C treatment of hepatic metastases from various malignancies was performed in 24 evaluable patients. An objective regression was obtained in 12 patients. The median survival of responders was 11 months compared with 3 months in nonresponders. No complication of the technical procedure occurred and the treatment was well tolerated. The only side effect of clinical importance was thrombocytopenia, which occurred at a median dose of 45 mg of Mitomycin C.

Bronchial angiography and intraarterial infusion of mitomycin-C were successfully performed in 39 of 47 patients with bronchogenic carcinoma. More than one course was given to several patients. No neurologic complications occurred and the side effects were insignificant. The pertinent anatomy of the bronchial and spinal arteries is summarized and a comprehensive description of the angiography and infusion technique is given. It is important that the infused artery is not occluded by the catheter and that the drug is properly diluted to avoid complications. The method appears to be of therapeutic value in the treatment of pulmonary carcinoma.

Bronchial artery infusion of mitomycin C might be very effective in treating minor tumors but, as a rule, less effective in the treatment of larger tumors. In order to achieve improved effect of treatment, 21 cases (stage II-III/TNM) were given supplementary chemotherapy with bleomycin or vincristine-bleomycin. Preoperative treatment was given to 11 cases in which indications for surgical treatment were primarily uncertain or absent. The other group consisted of 10 patients with inoperable lesions. Combined treatment has proved to have a strong but mainly local effect. Repeated courses (up to 5 times) were more effective than a single one. The regional effect, i.e: on overgrowth onto the mediastinum, pericardium or thoracic wall was weak. The system effect was negligible. Penetrating data about objective response are given.

Bronchial angiography was performed in 9 patients with squamous cell carcinoma of the lung. The tumor-feeding vessel was identified and infused with 10 mg of mitomycin-C (MMC) diluted in saline. At operation after 28 to 48 days complete remission of the tumor had occurred in 2 patients, almost complete in one, partial remission in 2 and a marked regression in 2. In 2 patients no change was noted. No side effects except moderate malaise and slight fever occurred.

Bronchial angiography was performed in 17 patients with advanced non-oat cell bronchogenic carcinoma. The patients were treated 1 to 5 times with infusions of 10 mg of mitomycin-C (MMC) into the tumor-feeding bronchial artery. All but 2 patients received in addition small doses of vincristine (intravenously) and bleomycin (intramuscularly) or only bleomycin to potentiate the effect of MMC. No major side effects occurred and the systemic toxicity was insignificant. An objective tumor reponse was encountered in 11/17 patients. Intraarterial chemotherapy is strictly local and therefore effective especially in patients with limited or locally advanced disease. In patients with more extensive disease an adjunctive therapy of a more regional or systemic modality must be given.

A technique is described for repeated superselective angiographic infusion of anticancer drugs into advanced malignant tumours of the head and neck region. The technique allows for a high concentration of the drug in the tumour and, furthermore, it is possible to ensure that the infused anticancer drug adequately reaches the tumour. Mitomycin C was given to 15 patients with advanced malignant tumours of the head and neck region. In 16 patients a partial remission was seen, and in another 5 patients a subjective improvement was reported. No complications were observed.

Selective bronchial angiography and short term intra-arterial infusions of Mitomycin C were performed in 70 patients with bronchogenic carcinoma. The courses were given 1--5 times with a median interval of 2 weeks. The angiograms were compared with chest radiograms and data obtained at bronchoscopy, mediastinoscopy, surgery or autopsy. The effect of therapy was evaluated with chest radiography and bronchoscopy. Among our first 36 patients an objective response was registered in 18/27 patients with squamous cell carcinoma, in 4/7 with adenocarcinoma and in 2/2 with small cell cancer. These results warrant further studies. Though not suitable as a routine procedure in the diagnostic work up of a patient with possible bronchogenic carcinoma bronchial angiogrpahy may contribute to a better staging when used e.g. in connection with intraarterial chemotherapy.