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

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.