Use of an automated circuit for isolated limb infusion for malignancy.
BACKGROUND
Isolated limb infusion (ILI) for recurrent or in-transit melanoma is an accepted technique that allows high-dose chemotherapy to be delivered to an extremity with minimal systemic toxicity. Current infusion systems have relied on manual delivery of drugs and circulation of blood during the treatment. Herein, we document our initial results with an automated circuit for ILI as an alternative to the manual technique.


METHODS
Patients undergoing ILI with an automated circuit for recurrent or advanced malignancy were identified. ILI was performed utilizing a Sarns 8000 roller pump attached to a Cobe 4:1 cardioplegia set with heat exchanger with a total priming volume of 80 ml. Melphalan (7.5 mg/L) and Dactinomycin (75 μg/L) doses which were corrected for ideal body weight were delivered via the infusion circuit after limb temperature reached 38 °C.


RESULTS
Fourteen lower extremity infusion procedures were performed in 10 patients. Successful infusion procedures were completed in all patients using the automated circuit. Constant flow rates of 50-70 cc/minute were achievable with the automated circuit. Acute toxicity and clinical results were similar to that reported with manual delivery systems.


CONCLUSIONS
ILI for advanced malignancy utilizing an automated circuit is feasible and safe. This automated system offers a safe and reliable alternative to the manual infusion technique.
Department of Surgery, Division of Surgical Oncology, University of Florida Gainesville, Florida, USA. stephen.grobmyer@surgery.ufl.edu
S R
SR
Grobmyer
L
L
Filichia
A R
AR
Robinson
T D
TD
Clark
K
K
Vaughn
E M
EM
Copeland
S N
SN
Hochwald
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D003609:Dactinomycin / Q000008:administration & dosage; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008545:Melanoma / Q000188:drug therapy*; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome
D003609:Dactinomycin; D008558:Melphalan