Isolated pelvic stopflow infusion technique for locally advanced gynaecological malignancy

ABSTRACT

This study included 45 patients who were classified into 2 groups Group I included 25 patients with locally advanced ovarian cancer; 8 patients received the standard chemotherapy and/or radiotherapy, 9 patients received isolated pelvic stop-flow infusion [IPSFI] with the intent of palliation and 8 patients received preoperative IPSFI with the intent of understaging, followed by surgical resection. Group II included 20 patients with locally advanced cancer cervix; 7 patients received the standard chemotherapy and/or radiotherapy [control group], 6 patients received IPSFI with the intent of palliation and 7 patients received preoperative IPSFI with the intent of understaging, followed by surgical resection. IPSFI was accomplished by placement of balloon- occlusion catheter in the aorta at L3 vertebral body level via the common femoral artery. Cytotoxic agents were infused into the aorta distal to the occlusion catheter through a pigtail catheter placed in the other limb. After 10-20 minutes, the aortic balloon was deflated and removed. So, it was concluded that isolated pelvic stop flow infusion improves the outcome of patients with advanced gynaecologic malignancies, as it enhances resectability, radio responsiveness and eradicates micrometastasis. PSFI with cisplatin and bleomycin, followed by radical surgery and postoperative radiotherapy is effective in treating advanced gynaecologic malignancies. PSFI increased tumour exposure to high drug concentration with minimal side effects and thus may be appropriate for patients with locally advanced gynaecologic malignancies