John F Thompson1, Peter C A Kam. 1. Sydney Melanoma Unit, Royal Prince Alfred Hospital, Camperdown, NSW, Australia. john.thompson@smu.org.au
Abstract
PURPOSE: Recurrent disease confined to a limb is a frequently encountered clinical problem in patients with melanoma. Regional chemotherapy by isolated limb perfusion (ILP) provides effective treatment but is invasive, complex and costly. Isolated limb infusion (ILI) is a simple yet effective alternative to ILP. MATERIALS AND METHODS: ILI involves drug administration into a limb via percutaneously inserted catheters after vascular isolation of the limb has been achieved with a tourniquet. The infused drug is circulated for 30 minutes via a simple extracorporeal circuit incorporating a heater (to produce mild hyperthermia). RESULTS: Limb tumour remission rates are similar to those achieved by conventional ILP. ILI is well tolerated, and elderly patients and those with major medical co-morbidities and serious peripheral vascular problems can be treated. CONCLUSIONS: ILI with mild hyperthermia is an established alternative to hyperthermic ILP for patients with recurrent limb melanoma. It can also be used for patients with soft tissue sarcomas and a variety of serious, chronic dermatological conditions.
PURPOSE: Recurrent disease confined to a limb is a frequently encountered clinical problem in patients with melanoma. Regional chemotherapy by isolated limb perfusion (ILP) provides effective treatment but is invasive, complex and costly. Isolated limb infusion (ILI) is a simple yet effective alternative to ILP. MATERIALS AND METHODS: ILI involves drug administration into a limb via percutaneously inserted catheters after vascular isolation of the limb has been achieved with a tourniquet. The infused drug is circulated for 30 minutes via a simple extracorporeal circuit incorporating a heater (to produce mild hyperthermia). RESULTS:Limb tumour remission rates are similar to those achieved by conventional ILP. ILI is well tolerated, and elderly patients and those with major medical co-morbidities and serious peripheral vascular problems can be treated. CONCLUSIONS: ILI with mild hyperthermia is an established alternative to hyperthermic ILP for patients with recurrent limb melanoma. It can also be used for patients with soft tissue sarcomas and a variety of serious, chronic dermatological conditions.
Authors: Kiran K Turaga; Georgia M Beasley; John M Kane; Keith A Delman; Stephen R Grobmyer; Ricardo J Gonzalez; G Douglas Letson; David Cheong; Douglas S Tyler; Jonathan S Zager Journal: Arch Surg Date: 2011-07
Authors: Heiner Ruschulte; Serena Shi; William W Tseng; Kerstin Kolodzie; Philip C Crawford; Darren B Schneider; Mohammed Kashani-Sabet; David Minor; Christian Apfel; Stanley Pl Leong Journal: BMC Anesthesiol Date: 2013-07-17 Impact factor: 2.217