TNF-alpha levels in patients with malignant tumors after hyperthermic isolated regional perfusion

Hyperthermic isolated regional perfusion is an alternative method for the treatment of malignancies especially sited in the pelvic region and extremities. The perfusion is performed via the extracorporeal system with a pump flow and chemotherapeutic agents and some cytokines, like tumor necrosis factor, may be added. It's well known that in the ischemia-reperfusion injury, hemorrhagic necrosis and cell death occurs and these cytokines are produced endogenously. In this study the endogenous TNF-alpha levels before, during and after hyperthermic isolated regional perfusion were compared in 16 patients with malignant tumors. The TNF-alpha levels were determined from the blood samples taken systemically before and after perfusion, and from perfusate at the 15th, 30th, 45th minute. The 15th minute samples were the ones where vascular clamps were applied to the vessels before starting the perfusion. TNF-alpha levels between the 15th minute samples and the blood samples that were taken systemically before and after perfusion were found statistically significant. The cause of this was suggested to be the ischemia-reperfusion injury in this period. It was shown in this study that high endogenous TNF-alpha levels and good clinical results could be achieved with hyperthermic isolated regional perfusion in the treatment of malignant tumors.