Regional perfusion of the pelvis: consideration of the "leakage" problem

Data on losses (or leakage) during clinical and experimental pelvic perfusion have been presented. An effort has been made in these studies to determine the relationship between the findings with various isotopes and the behavior of chemotherapeutic agents in these systems. It was found that the volume of distribution of the substance concerned was a primary factor affecting leakage. In view of the significantly smaller losses of isotopes and agents that had extravascular distribution, intravascular samples (Cr⁵¹or RISA) did not accurately reflect the transfer of specific chemotherapeutic agents. These studies also demonstrated less efficient clearing of drugs from the perfusion circuit by the "terminal flush" than could be accomplished with the intravascular isotopes. The therapeutic implications of these studies, as well as procedures employed to improve anatomic isolation, have been discussed.