From February 1982 to December 1983, 42 patients affected by neoplasms of the limbs were treated at the Istituto Nazionale Tumori of Milan by hyperthermic antiblastic perfusion in extracorporeal circulation at the temperature of 40-41 °C for 1 h. Thirty-two were affected by melanoma, 4 by osteogenic sarcoma, 2 by squamous-cell carcinoma, 1 by liposarcoma, 1 by hemangiopericytoma, 1 by clear-cell sarcoma and 1 by Kaposis's sarcoma. As regards the immediate response, a complete plus partial remission rate of 88 % without any major complication was obtained. The follow-up period is too short for any considerations about overall survival. However, because of these good clinical results we consider this method able to locally control the evolution of neoplasms of the extremities, allowing in many cases a limb salvage.
Get full access to this article
View all access options for this article.
References
1.
AyalaA.G., BruceMacKay, JaffeN., SutowW.W., BenjaminR., MurrayJ.A.: Osteosarcoma: the pathological study of specimens from en bloc resection in patients receiving preoperative chemotherapy. In: Status of the Curability of Childhood Cancers, pp. 127–144, Ed. van EysJ., and SullivanM.P., Raven Press, New York, 1980.
2.
CavaliereR., CiocattoE.C., GiovannellaB.C.: Selective heat sensitivity of cancer cells.Cancer, 20: 1351–1381, 1967.
3.
CavaliereR., MondovìB., MoriccaG., MonticelliG., MoioliP.G., SantoriS., Di FilippoF., CavallaroA.: Trattamento ipertermico dei tumori: basi biochimiche, applicazioni sperimentali, risultati clinici. In: L'ipertermia in Terapia Oncologica, pp. 187–257, BistolfiF. (ed.), Piccin, Padova, 1981.
4.
CavaliereR., Di FilippoF., MoriccaG., CavallaroA.: Hyperthermic treatment of melanoma of the limbs: the present status of knowledge. IIIrd Meeting of the European Group of Hyperthermia in Radiation Oncology. October 1981, Rotterdam.
5.
GiovannellaB.C., StehlinJ.S., MorganA.C.: Selective lethal aspects of supranormal temperature on human neoplastic cells.Cancer Res., 36: 3944–3950, 1976.
6.
GrossP., ParsonsP.G.: The effect of hyperthermia and melphalan on survival of human fibroblast strain and melanoma cell lines.Cancer Res., 37: 152–156, 1977.
7.
HuvosA.G., RosenG., MarcoveR.C.: Primary Osteogenic Sarcoma. Pathologic aspects in 20 patients after treatment with chemotherapy, en bloc resection, and prosthetic bone replacement.Arch. Pathol. Lab. Med., 101: 14–18, 1977.
8.
JanoffK.A., MoresonD., HolgrenH.: The treatment of melanoma of extremities with regional hyperthermic perfusion.Ann. Surg., 196: 316–323, 1982.
9.
JohnsonR.J.R., SandhuT.S., HetzelF.W., SongS.Y., BicherH.I., SubjeckJ.R., KowalH.S.: A pilot study to investigate skin and tumor thermal enhancement ratios of 41.5-42.0 °C hyperthermia with radiation.Int. J. Radiat. Oncol. Biol. Phys., 5: 947–953, 1979.
10.
KrementzE.T., CaterR.D., SutherlandC., RyanR.F.: Malignant Melanoma of the Limbs: An Evaluation of Chemotherapy by Regional Perfusion. pp. 375, Year Book Medical, Chicago, 1976.
11.
KrementzE.T., MuchmoreS.: Soft Tissue Sarcoma: Behaviour and Management. pp. 147–196, Year Book Medical, Chicago, 1983.
12.
MartjinH., OldhoffJ., Schraffordt KoopsH.: Regional perfusion in the treatment of patietns with a locally metastasized malignant melanoma of the limbs.Eur. J. Cancer, 17: 471–476, 1981.
13.
MartjinH., OldhoffJ., Schraffordt KoopsH.: Hyperthermic regional perfusion with melphalan and a combination of melphalan on actinomycin D in the treatment of locally metastasized malignant melanoma of the extremities.J. Surg. Oncol., 20: 9–13, 1982.
14.
McBrideC.R., SugarbakerE.V., HickeyR.C.: Prophylactic isolation perfusion as the primary treatment for invasive malignant melanoma of the limbs.Ann. Surg., 182: 316–321, 1975.
15.
NataliP.G.: Effect of hyperthermia and antineoplastic drugs on cell survival and antigenic profile of two human melanoma cell lines. In: Proceedings XIII International Congress of Chemotherapy, Abstract n. 246, SE 12.1.12/3, Vienna, 1983.
16.
OvergaardJ.: Fractionated reaction and hyperthermia. Experimental and clinical studies.Cancer, 48: 1116–1123, 1981.
17.
Schraffordt KoopsH., OldhoffJ., Van der PloegR., VermeyA., BelchuisH.: Some aspects of the treatment of primary melanoma of the extremities by isolated regional perfusion.Cancer, 39: 27–37, 1977.
18.
StehlinJ.S.Jr., ClarkR.L.: Experience with regional chemotherapy.Arch. Surg., 85: 84–90, 1962.
19.
StehlinJ.S.Jr., ClarkR.L.: Melanoma of the extremities: Experience with conventional treatment and perfusion in 339 cases.Ann. Surg., 110: 366–384, 1965.
20.
StehlinS., CiovannellaB.C., De IpolyiD., MuenzL.R., AndersonR.F.: Results of hyperthermic perfusion of melanoma of the extremities.Surg. Gynecol. Obstet., 140: 339–348, 1975.
21.
StehlinJ.S., GiovannellaB.C., De IpolyiP.D., AndersonR.F.: Results of eleven years experience with heated perfusion for melanoma of the extremities.Cancer Res., 39: 2255–2257, 1979.
22.
StormF.K., HarrisonW.H., ElliotR.S., MortonD.L.: Normal tissue and solid tumor effect of hyperthermia in animal models and clinical trials.Cancer Res., 39: 2245–2251, 1979.
23.
SutiH.D., PhilD.: Hyperthermic effects on animal tissues.Radiology, 123: 438–487, 1977.
24.
VagliniM.M., RoviniD., PradaA., NavaM., SantinamiM., AmmatunaM., CascinelliN.: Le perfusioni ipertermico-antiblastiche degli arti in circolazione extracorporea. Meccanica e fisiopatologia.Arg. Oncol., 3: 329–337, 1982.
25.
VagliniM., AmmatunaM., NavaM., PradaA., RoviniD., SantinamiM., CascinelliN.: Regional perfusion at high temperature in treatment of stage IIIA-IIIAB melanoma patients.Tumori, 69: 585–588, 1983.
26.
VagliniM., AndreolaS., AttiliA., BelliF., MaroldaR., NavaM., PradaA., SantinamiM., CascinelliN.: Limb-salvage procedure in two patients with spindle cell carcinoma of lower extremities using isolation perfusion.Tumori, 71: 271–275, 1985.
27.
VagliniM., SantinamiM., BelliF., NavaM.: Surgical technique of isolation perfusion.J. Extracorp. Circ., in press, 1985.
