Clinical Guidelines and Technical Standards for Intratumoral Injection of Chlorine Dioxide-Treatment Protocol

Currently, the collaborating clinics in Mexico and the Philippines will provide treatment for advanced cancer patients based on the following basic clinical guidelines, and more collaborating clinics are gradually joining my network.

Over 21 days, each patient should receive four intratumoral injections to cover all visible tumors, with about a 7-day interval between injections. The sequence of injections is as follows:

1. First Injection: Use the chlorine dioxide injection based on distilled water.

2. Second Injection: Use the chlorine dioxide injection based on saline.

3. Third Injection: Use the distilled water-based chlorine dioxide injection again.

4. Fourth Injection: Use the saline-based chlorine dioxide injection.

Initial Injection Protocol for Each Tumor:

• Single-Point Injection: For tumors with a maximum diameter less than 4 cm, inject directly into the tumor center with a dose that is 30% of the tumor's volume. For example, if the tumor is 33 milliliters, the injection amount would be 10 milliliters.

• Multi-Point Injection: For tumors with a maximum diameter over 4 cm, use a multi-point strategy. Divide the tumor evenly along the longest diameter, ensuring each section's diameter is close to but does not exceed 4 cm. Inject at the center of each section, with each injection dose being 30% of that section's volume.

Pain Management: Intratumoral injection of chlorine dioxide may cause significant pain. An anesthesiologist should provide real-time support during the procedure.

CT or Ultrasound Contrast Examination: During the four-injection process, conduct two CT or ultrasound contrast checks to assess tumor ablation. Perform the first examination 48 hours after the initial injection to adjust subsequent doses. Increase the second injection dose to 35% of the tumor volume if ablation is incomplete. If it's complete, do not adjust or slightly reduce the dose. The overall goal is to ensure complete tumor ablation after four injections.

After each injection, tumor volume may temporarily increase (swelling). This is normal, and the swelling typically subsides within 24 hours.