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Treatment of unresectable malignant abdominal, pelvic and thoracic tumors using abdominal pelvic and thoracic stop-flow chemotherapy.

BACKGROUND
Stop-flow perfusion (SFP) has been recently used to enhance the effects of chemotherapy in patients with locally advanced tumors.


PATIENTS AND METHODS
Over a 2-year period we performed abdominal, pelvic and thoracic SFP in 12 patients with unresectable or metastatic tumors, using balloon catheters inserted into the abdominal aorta and inferior vena cava. Blood flow was occluded and hypoxic extracorporeal perfusion or SFP was performed for advanced diseases. The chemotherapeutic agents were directly administered into the aorta and/or inferior vena cava for thoracic SFP. The procedure was repeated in each patient, with one-month interval between sessions. Haemofiltration was also applied in two patients with generalized abdominal disease in order to reduce systemic toxicity.


RESULTS
At post-operative CT or MRI follow-up, tumor shrinkage of more than 50% was observed in six patients, while post-SFP chemotherapy surgical resection of the tumors became feasible in four cases. The relief of pain, wherever present, was dramatic in the immediate post-operative period. Overall clinical improvement was achieved in all 12 patients. Post-operative recovery was uneventful in all but two patients, who developed minor systemic toxicity.


CONCLUSION
SFP appears to be a safe technique with low morbidity which improves the quality of life of cancer patients and allows satisfactory control of locally advanced tumors and metastatic carcinomatosis.