Hyperthermic isolated regional perfusion for the treatment of osteosarcoma in the lower extremity.
BACKGROUND
In order to reduce the systemic toxity of cisplatin and to increase the effect on the local tumor, facilitating limb-preserving procedures, we have been using hyperthermic isolated regional perfusion (HIRP) for the treatment of osteosarcoma in addition to preoperative chemotherapy.


METHODS
Twenty patients with an osteosarcoma in a lower extremity were treated with both preoperative chemotherapy and HIRP.


RESULTS
The chemotherapeutic effects of preoperative chemotherapy with HIRP was grade III in 6, and grade IV (no viable cell areas observed) in 7. The surgical margins could be reduced in these 13 cases of good responders showing over 90% necrosis (grade III or grade IV), which mainly involved postnecrotic fibrosis and osteosclerosis.


CONCLUSIONS
HIRP can help to control the tumor locally. A more conservative operation was then possible in cases of good responders to preoperative chemotherapy with HIRP.
Nakano
H
H
Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Tateishi
A
A
Miki
H
H
Imamura
T
T
Cho
S
S
Abe
S
S
Matsushita
T
T
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007866:Leg; D008297:Male; D012516:Osteosarcoma / Q000628:therapy*; D011300:Preoperative Care; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D002945:Cisplatin