title: Isolated pelvic perfusion in irradiated unresectable recurrence of pelvic tumor: preliminary outcome and ongoing study.
abstract: The technique of isolated pelvic perfusion (IPP) using extracorporeal circulation is capable of delivering high dose chemotherapy in the pelvic cavity. This technique has improved over time, notably with the use of a G-suit placed and inflated above the iliac bifurcation to impede flow through percutaneous vascular routes. This approach is of potential value in patients with previously irradiated, locally advanced recurrences of cancer originating from the gynecological or gastrointestinal organs. Administration of tumor necrosis factor alpha (TNF-α) in combination with melphalan seems to provide response rates similar to those obtained in the technique of isolated extremity perfusion. A preliminary phase I study has shown promising results in terms of feasibility and response rates. A randomized study is currently underway to compare IPP to standard treatment in patients with unresectable recurrent pelvic tumors of gynecological or gastrointestinal origin.
authors.affiliation: Département de chirurgie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France. Electronic address: catherine.uzan@igr.fr.
authors.forename: C
authors.initials: C
authors.lastname: Uzan
authors.affiliation: Département de chirurgie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: D
authors.initials: D
authors.lastname: Goere
authors.affiliation: Département de chirurgie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: F
authors.initials: F
authors.lastname: Dumont
authors.affiliation: Département de chirurgie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: S
authors.initials: S
authors.lastname: Gouy
authors.affiliation: Département d'anesthésie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: J
authors.initials: J
authors.lastname: Muret
authors.affiliation: Département de radiologie interventionnelle, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: A
authors.initials: A
authors.lastname: Hakime
authors.affiliation: Département de radiologie interventionnelle, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: T
authors.initials: T
authors.lastname: De Baere
authors.affiliation: Département de chirurgie, institut Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
authors.forename: S
authors.initials: S
authors.lastname: Bonvalot
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010386:Pelvic Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage
chemical_list: D000970:Antineoplastic Agents; D014409:Tumor Necrosis Factor-alpha; D008558:Melphalan
keywords: Loco-regional chemotherapy; Melphalan; Pelvic perfusion; Surgery; TNF-α