Guidelines for Intratumoral Injection of Chlorine Dioxide in Breast Cancer
Clinical Guidelines and Technical Standards for Intratumoral Injection of Chlorine Dioxide-9
Here’s the translation of the summarized content about the internal injection of chlorine dioxide therapy:
No Side Effects: This therapy can be safely administered to normal bodies without causing side effects.
Rapid Tumor Ablation: According to relevant guidelines, after 4 injections, 100% of all visible tumors can be ablated.
Convenient Injection Process: Each injection is very simple, similar to a puncture biopsy, and with existing advanced equipment, the injection time for each tumor does not exceed 5 minutes.
No Selectivity Based on Cancer Stage: This therapy has no selectivity regarding the stage of cancer; regardless of how advanced the cancer is, 100% tumor ablation can be achieved within 1 month.
Suitable for Continuous Treatment: This method can be used for ongoing treatment, ensuring that recurrence is no longer a concern for patients.
In summary, this therapy is considered a safe, fast, and effective method for tumor treatment.
9.1 Indications
9.1.1 Breast cancer at any stage.
9.1.2 Recurrence after radical mastectomy or chemoradiotherapy.
9.1.3 Metastasis to the breast pectoralis or supraclavicular lymph nodes.
9.1.4 Distant organ metastasis from breast cancer.
9.1.5 Normal bleeding and clotting times.
9.2 Contraindications
9.2.1 Inflammatory breast cancer.
9.2.2 Platelet count < 60×10⁹/L.
9.3 Pre-treatment Preparation
9.3.1 Complete pre-treatment examinations:
Blood count and coagulation tests.
Liver and kidney function tests.
Tumor markers: ER, PR, HER2, CA153, CEA.
Imaging: Mammography, breast ultrasound, abdominal and neck/axillary ultrasound, CT of the chest and brain.
Histopathological diagnosis.
9.3.2 Discuss the procedure and obtain consent, addressing possible complications such as fever, local skin ulcers, and pain.
9.3.3 Administer intramuscular injections of 0.1g butorphanol, 1KU antihemorrhagic agent, and 4-8mg ondansetron 15 minutes before treatment.
9.4 Puncture Needle and Auxiliary Equipment
Use a 23G×15.0 cm or 25G×9.0 cm puncture needle, syringe, 10ml and 20ml syringes, and ultrasound or CT machine.
9.5 Treatment Procedure
9.5.1 Select the puncture site under ultrasound or CT guidance.
9.5.2 Disinfect the skin, wear sterile gloves, and cover with a sterile drape.
9.5.3 Use 2% lidocaine for local anesthesia, stabilize the puncture site with the left hand, and insert the needle into the tumor center with the right hand.
9.5.4 Withdraw the needle core, connect a high-pressure syringe, and slowly inject chlorine dioxide solution under ultrasound or CT guidance. For tumors ≤4 cm, use single-point injection based on 30% of the tumor volume (ml). For tumors >4 cm, use multi-point injections with the same volume calculation.
9.5.5 After injection, remove the needle, cover with sterile gauze, and secure with tape.
9.5.6 Observe for 5–10 minutes post-procedure and then send the patient back to the ward.
9.6 Post-treatment Care
9.6.1 Monitor for redness, swelling, ulceration, pain, fever, and fatigue, and treat any complications promptly.
9.6.2 Check blood counts twice weekly, monitor WBC and PLT changes. Use granulocyte colony-stimulating factor if WBC < 4.0×10⁹/L, interleukin-11 for PLT < 80×10⁹/L, and oral iron supplements for Hb < 80g/L; transfusion if Hb < 60g/L.
9.6.3 Conduct weekly liver and kidney function tests to check for any damage.
9.6.4 After one treatment cycle, assess peripheral blood T lymphocyte subsets (CD4, CD8), and relevant molecular biological markers and genes.
9.7 Experience and Complications Management
9.7.1 For local redness, heat, and pain, provide anti-infective treatment and magnesium sulfate wet compress to reduce swelling.
9.7.2 For exudation or ulceration, apply ozone treatment locally to keep the wound clean and dry.
9.7.3 Skin ulceration post-treatment can occur due to drug leakage or shallow puncture. Choose puncture points near the base to avoid irritating the skin. Post-treatment, apply a local wet compress to reduce congestion and edema.