[Efficacy of the tumor necrosis factor-alpha (rTNF-alpha) associated with interferon-gamma and chemotherapy in extracorporeal circulation in the limb in inoperable malignant melanoma, soft tissue sarcoma and epidermoid carcinoma. A 4-year experience].
The authors review their experience of 4 years with isolated limb perfusion for the application of high dose TNF-alpha associated to IFN-gamma and melphalan for the treatment of regionally advanced tumours such as malignant melanoma, soft tissue sarcoma and epidermoid carcinoma. In malignant melanoma, the complete remission rate reaches 91%. In irresectable soft tissue sarcoma, this treatment when used as a neoadjuvant treatment saves the limb from amputation in 87.5% of the cases. Similar results are obtained for epidermoid carcinoma. With the regional application of high doses of TNF-alpha associated to chemotherapy and IFN-gamma, it has been possible to validate the concept of a strategy based on a dual targeting, that is the selective impact of the intratumoral vessels by TNF-alpha and of the tumour cells by chemotherapy. This approach appears to be the treatment of choice for locally advanced tumours of the limbs. However, as a single therapy, this procedure should be considered in melanoma as an induction therapy, and in sarcoma, as a preoperative treatment.
Lejeune
F
F
Centre pluridisciplinaire d'oncologie, CHUV, Lausanne, Suisse.
Liénard
D
D
Eggermont
A
A
Schraffordt Koops
H
H
Rosenkaimer
F
F
Gérain
J
J
Klaase
J
J
Kroon
B
B
Schmitz
P
P
D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001132:Arm; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology; D010478:Chemotherapy, Cancer, Regional Perfusion; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use*; D007866:Leg; D008558:Melphalan / Q000008:administration & dosage / Q000627:therapeutic use*; D009367:Neoplasm Staging; D018227:Sarcoma, Clear Cell / Q000188:drug therapy* / Q000473:pathology; D012983:Soft Tissue Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000627:therapeutic use*
D018906:Antineoplastic Agents, Alkylating; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma; D008558:Melphalan