PMID- 12874508
OWN - NLM
STAT- MEDLINE
DCOM- 20040112
LR  - 20190922
IS  - 1040-8746 (Print)
IS  - 1040-8746 (Linking)
VI  - 15
IP  - 4
DP  - 2003 Jul
TI  - Hyperthermic isolated limb perfusion in the management of extremity sarcoma.
PG  - 300-3
AB  - High local drug concentrations can be achieved in a limb with minimal systemic 
      toxicity with the technique of hyperthermic isolated limb perfusion (HILP). The 
      currently most successful drugs are still Tumor Necrosis Factor alpha (TNFalpha) 
      and melphalan. With HILP, as an induction chemotherapy treatment of locally 
      advanced primarily irresectable soft tissue sarcomas of a limb, a limb salvage 
      rate of 71% can be achieved, with a minimal treatment related morbidity. For the 
      HILP is no upper age limit. Systemic inflammatory response syndrome is currently 
      seldom seen. The exact working mechanisms of TNFalpha are still unknown. 
      Experimental work is now directed to the development of drugs sensitizing the 
      tumor vasculature to the effects of TNFalpha. In the clinical HILP setting are 
      currently lower doses of TNFalpha in combination with melphalan investigated. 
      Although multidrug resistance (MDR) is a major issue in effectiveness of 
      chemotherapy in human cancer treatment, HILPs with TNFalpha and melphalan did not 
      induce MDR in sarcomas. The future research in HILP with TNFalpha is directed in 
      increasing tumor sensitivity for TNF with lowering the dosage without decreasing 
      tumor response.
FAU - Hoekstra, H J
AU  - Hoekstra HJ
AD  - Division of Surgical Oncology, Department of Surgery, Groningen University 
      Hospital, PO Box 30.001, 9700 RB Groningen, The Netherlands. 
      h.j.hoekstra@chir.azg.nl
FAU - van Ginkel, R J
AU  - van Ginkel RJ
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Curr Opin Oncol
JT  - Current opinion in oncology
JID - 9007265
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Tumor Necrosis Factor-alpha)
RN  - Q41OR9510P (Melphalan)
SB  - IM
MH  - Antineoplastic Agents/*administration & dosage/therapeutic use
MH  - Chemotherapy, Cancer, Regional Perfusion
MH  - Extremities
MH  - Humans
MH  - *Hyperthermia, Induced
MH  - Melphalan/*administration & dosage/therapeutic use
MH  - Sarcoma/*therapy
MH  - Soft Tissue Neoplasms/*therapy
MH  - Tumor Necrosis Factor-alpha/administration & dosage/therapeutic use
RF  - 12
EDAT- 2003/07/23 05:00
MHDA- 2004/01/13 05:00
CRDT- 2003/07/23 05:00
PHST- 2003/07/23 05:00 [pubmed]
PHST- 2004/01/13 05:00 [medline]
PHST- 2003/07/23 05:00 [entrez]
AID - 10.1097/00001622-200307000-00004 [doi]
PST - ppublish
SO  - Curr Opin Oncol. 2003 Jul;15(4):300-3. doi: 10.1097/00001622-200307000-00004.