May 1993

Isolated Pelvic Perfusion for Unresectable Cancer Using a Balloon Occlusion Technique

Author Affiliations

From the Department of Surgery (Drs Turk, Leenen, and Wanebo) and the Divisions of Medical Oncology (Dr Darnowski) and Nephrology (Dr Weinberg), Roger Williams Medical Center, Brown University, and the Department of Chemistry, Providence College (Dr Belliveau), Providence, RI. Dr Turk is currently affiliated with Randolph Surgical Associates, Charlotte, NC.

Arch Surg. 1993;128(5):533-539. doi:10.1001/archsurg.1993.01420170067009

• Previously irradiated recurrent pelvic malignancy is refractory to most treatment modalities. Ten patients with local recurrences (six with rectal cancer; three, anal cancer; and one, anorectal melanoma) were treated with a total of 17 courses of isolated pelvic perfusion chemotherapy (12 with multiple agents) using standard hemodialysis technology. Aortic and inferior vena caval occlusion was maintained via transfemoral balloon catheters, with a single intraoperative balloon disruption. Mean pelvic-systemic drug exposure ratios were 9.8:1 for fluorouracil, 4.8:1 for cisplatin, and 4.4:1 for mitomycin C. Results were three partial responses (two patients subsequently underwent resection) and three minor responses, all in patients with a visible tumor. Pelvic pain was relieved in six of eight symptomatic patients (mean duration, 4 months). Using limited access, this procedure produces high pelvic-systemic concentration gradients, prolonged palliation for recurrent pelvic cancers, and increased resectability in selected patients.

(Arch Surg. 1993;128:533-539)