Caren van Roekel

302 Chapter 11 FIGURE 9. Intention-to-treat analyses of effect of anti-reflux catheter on T/N activity concentration ratio (a), mean tumor-absorbed dose (b), mean parenchymal-absorbed dose (c) and infusion efficiency (d). Chapter 9 describes the results of the SIM study, in which the effect of an anti- reflux catheter on tumor- to non-tumor activity concentration ratio, tumor- absorbed dose, parenchymal-absorbed dose and infusion efficiency was investigated. Twenty-one mCRC patients were treated in this study. The use of the Surefire anti-reflux catheter did not lead to improved tumor targeting (median tumor to non-tumor activity concentration ratio 3.2 versus 3.6 with a standard microcatheter), nor did it lead to improved infusion efficiency (0.04% vs. 0.03% residual activity for the standard microcatheter and anti-