Background
Cancer spreads through the lymphovascular system using the sentinel lymph nodes as the primary gateway to distant sites. Therefore, it is essential to eliminate cancer cells in the very first checkpoints and prevent from travelling further.
Scientists proved that lymphotropic method of treatment allows achieving significantly higher drug concentration (up to 3 times) in the targeted lymph nodes and targeted tissues with tumor than using regimes with intravenous administration of chemo drugs. This method allows decreasing drug dose and applying the drug locally to the affected organ and its lymphatic region, including sentinel lymph nodes.
The paper illustrates successful treatment cases of breast cancer with metastasis in regional lymph nodes with lymphotropic chemotherapy that is a subcutaneous administration of modified cytostatics’ solution to the lymphatic region of breast and metastasis.
Methods and materials
Three cases with female breast cancer with SNL and distant metastasis received CMF (cyclophosphamide, methotrexate, fluorouracil) alone as a first line chemotherapy.
Lymphotropic chemotherapy is a targeted administration of cytostatics to the organ affected by cancer and to SNL. The method is performed as weekly subcutaneous injections cytostatics in the lymphatic region.
Targeted administration ensures lowering single doses to the following figures (cyclophosphamide – 250 mg, methotrexate – 50 mg, fluorouracil – 200 mg).
Prior to the procedure drug composition is adjusted in order to be pH – neutral and do not significantly affect skin, tissues, interstice and lymphatic region when injected subcutaneously.
CT and lab control tests were performed.
Results
Case 1. Patient Us, female, 50 yo. Right breast cancer diagnosed in may 2013, mts in axillar LN. Neo-adjuvant CMF (200/50/250 mg) twice a week performed prior to radical resection. Histopathological tests after radical resection revealed no mts in regional and axillar LN.
Case 2. Patient St, female, 54 yo. Left breast cancer diagnosed in 2006. Radical resection and radiotherapy successful. Relapse in 2014, mts in liver, lungs, vertebra. CA 153-231 ME/ml. Lymphotropic CMF (200/50/250 mg) weekly started in october 2014 through march 2015. 20 single injections performed. Steady decrease in CA 153, mediastinal LN sizes, liver and vertebral mts achieved.
Case 3. Patient A, female, 65 yo. Breast cancer diagnosed in 2017, mts in regional LN, mts in ilium and pubic bone (pain syndrome). Lymphotropic CMF (200/50/250 mg) weekly started in February 2017. Achieved after 4 injections: instant decrease in CA 153, regional LN, reduction in pain syndrome dut to weakening of metastatic process in bones.
Injection site remained safe and satisfactory tolerance of treatment and good quality of life achieved in all cases.
Conclusion
Lymphotropic chemotherapy can be considered as a mean to prevent spreading of cancer cells through the lymphatic system via SNL and to eliminate primary tumor itself. The following destinations of breast cancer metastasis can be covered with lymphotropic injections of cytostatics: regional metastasis in breast, axillar LN, inguinal LN, supraclavicular and subclavian LN, parasternal LN; distant metastasis in mediastinal LN, lungs, liver.