Isolated regional chemotherapeutic perfusion oflimbs

Among patients suffering from diseases such as skin melanoma, skin cancer and soft tissue sarcoma, there is a group with locally advanced forms. Standard treatment options may not be effective. For some patients, limbsparing approach is often not possible. Amputation decrease quality of life. Isolated regional perfusion - the method of temporary isolation of the affected limb with the implementation of cardiopulmonary bypass and chemotherapy agents loaded in it. The method of ILP was developed to be able to achieve regional concentrations of chemotherapeutic agents that are 15 to 25 times higher than can be reached with systemic administration, but without the systemic sideeffects. Melphalanbased ILP is associated with complete response rates of 40-50%, and overall response rates of 75-80%. When Tumor Necrosis Factor-alfa was introduced in the isolated limb perfusion model by Lejeune and Lienard in 1988, complete response rates of 80-90% were reported. Multicenter trials confirmed that TNFbased ILP was a highly effective new method of induction biochemotherapy for extremity soft tissue sarcomas with a 20-30% complete remission rate, a 50% partial remission rate and a limb salvage percentage of 80%. We treated 2 patients in RCRC N.N. Blokhin RAMS with isolated limb perfusion with melfalan and mild hyperthermia. Progression not observed for 9 months.

isolated regional perfusion, melanoma, sarcoma, melfalan, tumor necrosis factor-α, hyperthermia, cardiopulmonary bypass

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