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Isolated Pelvic Perfusion for Unresectable Cancer Using a Balloon Occlusion Technique

Peter S. Turk, MD; James F. Belliveau, PhD; James W. Darnowski, PhD; Marc C. Weinberg, MD; Luke Leenen, MD, PhD; Harold J. Wanebo, MD
Arch Surg. 1993;128(5):533-539. doi:10.1001/archsurg.1993.01420170067009.
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• 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)


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