Adriamycin in hyperthermic perfusion for advanced limb sarcomas

From February 1989 to April 1991, 12 hyperthermic limb perfusions (HLP) with adriamycin (ADR) were performed in 12 patients with high grade soft tissue sarcomas (9 in the leg and 3 in the arm); two were at A.J.C. stage IIb, eight stage IIIb and two stage IV. ADR (0.7-1.5 mg/kg) was administered in bolus at a mean temperature of 41.5 degrees C and perfused for 60 min. No systemic toxicity was reported; seven patients had grade II locoregional toxicity, another four grade III and one grade IV. Tumor necrosis (radiological evaluation) was less than 25% in two patients, 25% to 50% in two, 50% to 75% in five and greater than 75% in three. Limb sparing surgery was feasible in ten patients. At present eight patients are alive; three had local recurrence and four distant metastases.