Choice of agent and prediction of systemic toxicity in isolated hyperthermic limb perfusion

Neades, G. T., Evans, W. D. ORCID: https://orcid.org/0000-0003-0013-8205 and Mansel, R. E. ORCID: https://orcid.org/0000-0002-8051-0726 1991. Choice of agent and prediction of systemic toxicity in isolated hyperthermic limb perfusion. Regional Cancer Treatment 3 (6) , pp. 252-255.

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Abstract

Between 1985 and 1989 35 isolated hyperthermic limb perfusions were performed for melanoma confined to the extremities. Twenty-six perfusions were performed using melphalan, 1-2 mg/kg (9 adjuvant, 17 therapeutic) and 9 using cisplatin 75-150 mg/m² (all therapeutic). Recurrent tumour was not excised to provide evidence of objective response to the cytotoxic agent. During 24 such perfusions I-125 labelled human serum albumin (HSA) leakage from the perfusion circuit was measured and correlated with observed systemic toxicity. A response to melphalan was seen in 15/17 patients (88%): 13/15 complete responses and 2/15 partial responses; and in 3/9 patients (33%): 2/3 complete and 1/3 partial responses, perfused with cisplatin. Duration of response after melphalan ranged from 5 months to 48 months and after cisplatin from 4 to 19 months. Bone marrow depression was seen in 8 cases; all had received melphalan. Systemic toxicity was predicted by high leak rates of I-125 HSA after 10 min (P < 0.05). Melphalan remains the drug of choice in isolated hyperthermic limb perfusion for malignant melanoma and systemic toxicity from the drug may be predicted by I-125 HSA studies.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Springer-Verlag
ISSN:	0935-0411
Last Modified:	10 Nov 2022 10:11
URI:	https://orca.cardiff.ac.uk/id/eprint/145941

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