Safe, compact and portable system for regional chemotherapeutic hyperthermic perfusion procedures.
Perfusion techniques utilizing hyperthermic chemotherapy have been established as a successful modality of therapy for isolated metastatic malignant melanoma.  The combination of chemotherapeutic agents (Dactinomycin, thiotepa and Mechlorethamine HCl) given in high doses, not possible systemically, combined with hyperthermia (40-42 degrees C) in an isolated extremity has shown greater tumor regression compared with systemic medication only.  Many of the isolated limb perfusion procedures are performed in non-cardiac centers, especially at specialized cancer institutions.  This often presents new obstacles for the perfusionist including lack of adequate perfusion equipment and disposables.  Other obstacles include unfamiliarity of the operating room staff with the heart-lung machine and inappropriate and/or unsafe handling of the perfusion circuit.  In order to overcome these obstacles and enhance safety, portability and effectiveness, the authors have developed an isolated limb perfusion system.  The purpose of this study was to compare the parameters of treatment and long term outcomes demonstrated by our system and method, to previously published data.  The qualitative comparative analysis was performed between eight treatments with this type of perfusion system and outcome data previously published.  It is the authors' conclusion that the portable isolated limb perfusion system achieved all of the required parameters to provide safe and effective treatment for this type of melanoma.  No demonstrated variation of the long term clinical results in our patient population was seen when compared to previously published data.
Fried
S J
SJ
LAC/USC Medical Center, Department of Surgery.
Miller
R
R
Weaver
F A
FA
Faddis
D
D
D000328:Adult; D000368:Aged; D001132:Arm; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000295:instrumentation* / Q000379:methods; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000008:administration & dosage* / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation / Q000379:methods*; D007866:Leg; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage* / Q000627:therapeutic use; D008545:Melanoma / Q000188:drug therapy / Q000628:therapy*; D008875:Middle Aged; D013852:Thiotepa / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome