S. Hill et al., LOW-DOSE TUMOR-NECROSIS-FACTOR-ALPHA AND MELPHALAN IN HYPERTHERMIC ISOLATED LIMB PERFUSION, British Journal of Surgery, 80(8), 1993, pp. 995-997
Nine patients with soft tissue tumours of the lower limb not amenable
to treatment other than by isolated limb perfusion or amputation under
went hyperthermic isolated limb perfusion at the level of the superfic
ial femoral vessels, using a combination of recombinant tumour necrosi
s factor (TNF) alpha and melphalan. In seven patients with superficial
tumours, necrosis and sloughing was apparent within 48 h of perfusion
. All patients experienced a complete tumour response. There were no s
ystemic side-effects associated with the use of TNF-alpha although loc
al side-effects, particularly oedema, were pronounced. Three patients
ultimately required amputation because of the large soft tissue defect
s that resulted from necrosis of the tumour and overlying skin.