e13561 Background: Isolated pelvic perfusion (IPP) may have value in therapy of recurrent pelvic malignancy following previous surgery and chemoradiation. We performed 113 IPP in 78 such pts (34 palliation, and 44 pre op) using a simplified balloon occlusion technique. Methods: Of 42 patients (pts) with recurrent rectal cancer (ca), 26 had preop and 16 had palliative IPP. Other pelvic cancers included anal canal (8 pts), pelvic sarcoma (5 pts), melanoma (M) (4 pts), endometrial ca (EC) 2 pts, ovarian ca (OC) 2 pts, and bladder ca (BC) 1 pt. Chemo agents included Paclitaxel, 5FU, cisplatinum, or Oxaliplatin and mitomycin for epithelial cancer and (Doxorubicin, Ifosamide, Phenyl Alanine Mustard (PAM) for remaining tumors. High dose IPP with PAM, Paclitaxel and Cisplatin was given in 6 pts, 3 with stem cell support. Results: Palliative IPP in advanced rectal cancer (AdRca) pts relieved narcotic resistant pain (2-4 mos) in 11/16 pts (69%). Preop IPP in 26 AdRca achieved path CR in 2 pts and partial regression in 11 pts; 7 had RO resection. Of 5 other pts, 3 refused resection, 2 were inoperable. Median survival was 17 mos in 12 resectable pts and 30 mos in 7 resected pts and 8 mos in 12 non resectable pts. It was 30 months in 8 pts with anorectal ca (1>90 mos), 20 mos in 4 endometrial/ovarian ca pts, (1 died NED >48 mos), 13 mos in 4 M pts and 5 (4-34) mos in 5 pelvic sarcoma pts. Overall 17 of 44 (39%) were resected and 24 were palliated with IPP. Conclusions: IPP has value in palliating or augmenting resectability and survival in advanced pelvic cancer patients not amenable to conventional chemoradiation and surgery.
Hypoxic Pelvic Perfusion With Mitomycin C Using a Simplified Balloon-Occlusion Technique in the Treatment of Patients With Unresectable Locally Recurrent Rectal Cancer
