Selected hypoxic stop-flow perfusions: indication and limits.
OBJECTIVE
The treatment of unresectable cancers is still one of the main medical challenges. Stop-flow perfusion has been used as locoregional chemotherapy based on blood supply blockage of the tumor-bearing area. The aim of the present paper is to report our personal experience in the clinical use of hypoxic stop-flow perfusion and discuss future prospects for research.


METHODS
Since December 1997 more than 500 stop-flow perfusions have been performed at the University of L'Aquila. Hypoxic perfusion was adopted for the following indications: recurrent rectal cancer, advanced pancreatic cancer, recurrent pelvic and limb melanoma, and recurrent limb melanoma.


RESULTS
For recurrent rectal cancer median survival was 12.2 months, for advanced pancreatic cancer 9.6 months, for recurrent pelvic and limb melanoma 34.4 months, and for recurrent limb melanoma 23.8 months.


CONCLUSIONS
Based on these encouraging results, stop-flow perfusion should be considered an effective treatment. Future fields of research include tailored chemotherapy and hyperthermia.
Guadagni
Stefano
S
Department of Surgical Sciences, University of L'Aquila, L'Aquila, Italy. stefanoguadagni@interfree.it
Kanavos
Evangelos
E
Schietroma
Mario
M
Fiorentini
Giammaria
G
Amicucci
Gianfranco
G
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D015687:Cell Hypoxia; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods* / Q000639:trends; D002945:Cisplatin / Q000008:administration & dosage; D003606:Dacarbazine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D005472:Fluorouracil / Q000008:administration & dosage; D006440:Hemofiltration; D006801:Humans; D053208:Kaplan-Meier Estimate; D008545:Melanoma / Q000628:therapy; D008558:Melphalan / Q000008:administration & dosage; D016685:Mitomycin / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D009369:Neoplasms / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000628:therapy; D010386:Pelvic Neoplasms / Q000628:therapy; D012004:Rectal Neoplasms / Q000628:therapy; D016896:Treatment Outcome
D015251:Epirubicin; D016685:Mitomycin; D003606:Dacarbazine; D004317:Doxorubicin; D002945:Cisplatin; D008558:Melphalan; D005472:Fluorouracil