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[New modifications in isolated extremity perfusion ].

K Aigner, P Hild, M Hundeiker

    Zeitschrift Fur Hautkrankheiten
    |July 15, 1982
    PubMed
    Summary
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    Hyperthermic isolated extremity perfusion effectively treats advanced melanoma. Different chemotherapy drugs show tumor regression, but careful temperature control is crucial with cis-platinum to prevent nerve damage.

    Area of Science:

    • Oncology
    • Surgical Oncology
    • Pharmacology

    Context:

    • Advanced melanoma of the extremities presents a significant clinical challenge.
    • Hyperthermic isolated extremity perfusion (HIEP) is a regional chemotherapy technique.
    • This study evaluates HIEP in 117 patients treated between October 1979 and May 1981.

    Purpose:

    • To assess the efficacy of HIEP using various chemotherapeutic agents for advanced extremity melanoma.
    • To determine optimal perfusion conditions, particularly regarding temperature, for different agents.

    Summary:

    • HIEP was performed on 117 patients with advanced extremity melanoma.
    • Indications included American Joint Committee on Cancer staging above Level III and tumor thickness >1.5 mm.
    • Agents used included melphalan, melphalan/dactinomycin, nitrogen mustard/dactinomycin, DTIC, cis-platinum, and cis-platinum/dactinomycin. All demonstrated tumor regression in situ.

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  • Crucially, cis-platinum perfusion requires limiting hyperthermia to below 40°C to avoid neurological damage, necessitating a specific protocol for temperature management.

    • Impact:

    • HIEP demonstrates potential for tumor regression in advanced extremity melanoma.
    • The findings highlight the importance of tailored hyperthermia protocols based on the specific chemotherapeutic agent used.
    • Further long-term follow-up is required to establish definitive outcomes and survival benefits.