Loco-regional perfusions (stop-flow techniques): state of art and future

The treatment of primary advanced or unresectable recurrent cancers is still one of the main medical challenges. The Stop-flow perfusion has been used as loco-regional chemotherapy based on blood supply blockage of the tumour-bearing area. The aim of the present paper is to report the personal experience in the clinical use of stop-flow perfusions and discuss about future perspectives of research. Since December 1997 more than 400 Stop-flow perfusions have been performed at University of L'Aquila. The following types of indication have been selected: recurrent unresectable rectal cancer, advanced pancreatic cancer, thoracic lymphomas, recurrent non-small cell lung cancer, recurrent pelvic and limb melanoma, and recurrent limb melanoma. In this paper results are presented in terms of median survival. For recurrent rectal cancer median survival was 12.2 months, for advanced pancreatic cancer 9.6 months, for thoracic lymphomas 16 months, for recurrent non-small cell lung cancer 21 months, for recurrent pelvic and limb melanoma 34.4 months, for recurrent limb melanoma 23.8 months. Based on these encouraging results, Stop-flow perfusion should be considered an effective approach to locally advanced cancers. Future fields of research include personalized chemotherapy and perfusion under hyperthermic conditions.