title: Hyperthermic isolated limb perfusion for the treatment of soft tissue sarcomas.
abstract: Hyperthermic isolated limb perfusion (HILP) with various chemotherapeutic agents has been used for the local treatment of high-grade soft tissue sarcomas (STS) of the extremities, but in most cases, with a disappointing result. Most such regimens certainly should not be considered superior to surgery plus radiotherapy. Although the majority of extremity STS can be resected locally, some are very large and are in close proximity to bone, nerve or blood vessels. In these cases, amputation is the only means of resecting the tumour. A new combination of drugs used in the set-up of HILP with tumour necrosis factor-alpha and melphalan has emerged as a very promising option for the limb-saving management of locally advanced STS. In recent studies, complete response rates of approximately 30% and partial remission rates of 50% have been achieved, while the overall limb-salvage rate is more than 80%.
authors.affiliation: Department of Surgical Oncology, Groningen University Hospital, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Schraffordt Koops
authors.forename: A M
authors.initials: AM
authors.lastname: Eggermont
authors.forename: D
authors.initials: D
authors.lastname: Liénard
authors.forename: B B
authors.initials: BB
authors.lastname: Kroon
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
authors.forename: A N
authors.initials: AN
authors.lastname: Van Geel
authors.forename: O E
authors.initials: OE
authors.lastname: Nieweg
authors.forename: F J
authors.initials: FJ
authors.lastname: Lejeune
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005121:Extremities; D006801:Humans; D006979:Hyperthermia, Induced; D007371:Interferon-gamma / Q000008:administration & dosage; D008558:Melphalan / Q000008:administration & dosage; D011994:Recombinant Proteins; D012509:Sarcoma / Q000188:drug therapy*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000008:administration & dosage
chemical_list: D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma; D008558:Melphalan