Stop-flow technique for loco-regional delivery of antiblastic agents: literature review and personal experience.
OBJECTIVE
The therapeutic approach for primary or recurrent advanced solid tumours, particularly when unresectable, is still one of the main medical challenges in the management of cancer patients. The stop-flow (SF) technique has been recently proposed as a semi-invasive drug delivery system based on the blood supply blockage of the tumour-bearing area. Here, we discuss the principles underlying the SF technique as well as the worldwide experience published so far. We also report on the results of our pilot study on pelvic and limb SF perfusion.


METHODS
We reviewed the worldwide experience on SF as reported by the literature published on PubMed from 1990 through 2001. In our series, we treated 20 patients affected with locally advanced melanoma, soft tissue sarcoma or colorectal cancer.


RESULTS
This therapeutic modality - at least for some tumours - can achieve encouraging results in terms of clinical response even after conventional therapies have failed. Moreover, as a safe and relatively simple procedure, SF can be applied to patients for whom traditional treatments (i.e. surgery, systemic chemotherapy) are contraindicated because of poor general conditions.


CONCLUSIONS
At present, the SF technique should be considered an investigational approach to locally advanced cancers. The encouraging results obtained with this procedure should be validated by large phase III trials.
Pilati
P
P
Department of Oncological and Surgical Sciences, Clinica Chirurgica Generale II, University of Padova, via Giustiniani 2, 35128 Padova, Italy.
Mocellin
S
S
Miotto
D
D
Rossi
C R
CR
Codello
L
L
Foletto
M
M
Scalerta
R
R
Vieceli
G
G
Ceccherini
M
M
Nitti
D
D
Lise
M
M
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016503:Drug Delivery Systems / Q000379:methods* / Q000639:trends; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy; D010865:Pilot Projects
D000970:Antineoplastic Agents