Local and systemic toxicity in 'borderline true' hyperthermic isolated perfusion for lower limb melanoma

This paper reports clinical results of hyperthermal (41.5 degrees C) isolated perfusion of the lower limb for melanoma treatments in association with cytostatic drugs (L-PAM) in 10 consecutive patients. Attention is focussed on the toxicity effects in the search for a possible correlation between the treatment variables and toxicity. Careful heat administration techniques and thorough and accurate temperature monitoring have resulted in a uniform and closely controlled temperature distribution, allowing us to approach the limiting temperature value for possible damage both of the limb tissues and of the perfusate. Care was taken to avoid perfusate overheating (42 degrees C maximum). Local toxicity was observed between grades II and III. Systemic toxicity was of insignificant level. The clinical results show that high-temperature treatments with simultaneous administration of the cytostatic are feasible with acceptable toxicity. Further clinical investigations are recommended to ascertain the efficacy of the method.