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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.

Abstract
• 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)

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.

Footnotes
Accepted for publication January 24, 1993.

Presented at the 73rd Annual Meeting of the New England Surgical Society, Dixville Notch, NH, September 26, 1992.

Reprint requests to Department of Surgery, Roger Williams Medical Center, 825 Chalkstone Ave, Providence, RI 02908 (Dr Wanebo).

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