Toxicities associated with hyperthermic isolated limb perfusion and isolated limb infusion in the treatment of melanoma and sarcoma

Mecker Moller, James M. Lewis, Sophie Dessureault, Jonathan S. Zager

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Hyperthermic isolated limb perfusion (HILP) and isolated limb infusion (ILI) may play a significant role in the treatment of patients with recurrent or in transit extremity melanoma or sarcoma that is unresectable. These procedures may be indicated when patients are otherwise faced with the possibility of a debilitating amputation. Not entirely benign treatment modalities, HILP and ILI can be associated with regional and systemic toxicities. We conducted a literature search of published studies using HILP and ILI for the treatment of extremity sarcomas and melanomas, and associated toxicities was performed. The regional toxicities of HILP and ILI are similar. The most common toxicities reported are mild to moderate. However, when severe regional toxicity occurs, albeit infrequently (<5%), fasciotomies or even amputation may be necessary. Some studies have showed a relationship between acute regional toxicities and long term regional morbidity. Systemic toxicity appears to be more frequent when TNF-α is used in combination with other drugs during HILP, however the use of TNF-α in the United States is limited to trials. Although regional toxicities are similar, systemic toxicity of ILI is minimal compared to HILP. ILI is easier to repeat, technically less complex, and may be more acceptable in infirmed patients. Long term morbidity and outcomes for ILI are still being evaluated. Both of these techniques may be suitable options in patients with unresectable advanced or recurrent, or in transit extremity melanoma or sarcoma.

Original languageEnglish
Pages (from-to)275-289
Number of pages15
JournalInternational Journal of Hyperthermia
Volume24
Issue number3
DOIs
StatePublished - May 1 2008
Externally publishedYes

Fingerprint

Sarcoma
Melanoma
Extremities
Perfusion
Therapeutics
Amputation
Morbidity

Keywords

  • Extremity melanoma and sarcoma
  • Hyperthermic perfusion
  • Limb infusion
  • Regional and systemic toxicities

ASJC Scopus subject areas

  • Cancer Research
  • Radiological and Ultrasound Technology

Cite this

Toxicities associated with hyperthermic isolated limb perfusion and isolated limb infusion in the treatment of melanoma and sarcoma. / Moller, Mecker; Lewis, James M.; Dessureault, Sophie; Zager, Jonathan S.

In: International Journal of Hyperthermia, Vol. 24, No. 3, 01.05.2008, p. 275-289.

Research output: Contribution to journalArticle

@article{8b23c984700f495abf2bf8d74f0f49ca,
title = "Toxicities associated with hyperthermic isolated limb perfusion and isolated limb infusion in the treatment of melanoma and sarcoma",
abstract = "Hyperthermic isolated limb perfusion (HILP) and isolated limb infusion (ILI) may play a significant role in the treatment of patients with recurrent or in transit extremity melanoma or sarcoma that is unresectable. These procedures may be indicated when patients are otherwise faced with the possibility of a debilitating amputation. Not entirely benign treatment modalities, HILP and ILI can be associated with regional and systemic toxicities. We conducted a literature search of published studies using HILP and ILI for the treatment of extremity sarcomas and melanomas, and associated toxicities was performed. The regional toxicities of HILP and ILI are similar. The most common toxicities reported are mild to moderate. However, when severe regional toxicity occurs, albeit infrequently (<5{\%}), fasciotomies or even amputation may be necessary. Some studies have showed a relationship between acute regional toxicities and long term regional morbidity. Systemic toxicity appears to be more frequent when TNF-α is used in combination with other drugs during HILP, however the use of TNF-α in the United States is limited to trials. Although regional toxicities are similar, systemic toxicity of ILI is minimal compared to HILP. ILI is easier to repeat, technically less complex, and may be more acceptable in infirmed patients. Long term morbidity and outcomes for ILI are still being evaluated. Both of these techniques may be suitable options in patients with unresectable advanced or recurrent, or in transit extremity melanoma or sarcoma.",
keywords = "Extremity melanoma and sarcoma, Hyperthermic perfusion, Limb infusion, Regional and systemic toxicities",
author = "Mecker Moller and Lewis, {James M.} and Sophie Dessureault and Zager, {Jonathan S.}",
year = "2008",
month = "5",
day = "1",
doi = "10.1080/02656730701805520",
language = "English",
volume = "24",
pages = "275--289",
journal = "International Journal of Hyperthermia",
issn = "0265-6736",
publisher = "Informa Healthcare",
number = "3",

}

TY - JOUR

T1 - Toxicities associated with hyperthermic isolated limb perfusion and isolated limb infusion in the treatment of melanoma and sarcoma

AU - Moller, Mecker

AU - Lewis, James M.

AU - Dessureault, Sophie

AU - Zager, Jonathan S.

PY - 2008/5/1

Y1 - 2008/5/1

N2 - Hyperthermic isolated limb perfusion (HILP) and isolated limb infusion (ILI) may play a significant role in the treatment of patients with recurrent or in transit extremity melanoma or sarcoma that is unresectable. These procedures may be indicated when patients are otherwise faced with the possibility of a debilitating amputation. Not entirely benign treatment modalities, HILP and ILI can be associated with regional and systemic toxicities. We conducted a literature search of published studies using HILP and ILI for the treatment of extremity sarcomas and melanomas, and associated toxicities was performed. The regional toxicities of HILP and ILI are similar. The most common toxicities reported are mild to moderate. However, when severe regional toxicity occurs, albeit infrequently (<5%), fasciotomies or even amputation may be necessary. Some studies have showed a relationship between acute regional toxicities and long term regional morbidity. Systemic toxicity appears to be more frequent when TNF-α is used in combination with other drugs during HILP, however the use of TNF-α in the United States is limited to trials. Although regional toxicities are similar, systemic toxicity of ILI is minimal compared to HILP. ILI is easier to repeat, technically less complex, and may be more acceptable in infirmed patients. Long term morbidity and outcomes for ILI are still being evaluated. Both of these techniques may be suitable options in patients with unresectable advanced or recurrent, or in transit extremity melanoma or sarcoma.

AB - Hyperthermic isolated limb perfusion (HILP) and isolated limb infusion (ILI) may play a significant role in the treatment of patients with recurrent or in transit extremity melanoma or sarcoma that is unresectable. These procedures may be indicated when patients are otherwise faced with the possibility of a debilitating amputation. Not entirely benign treatment modalities, HILP and ILI can be associated with regional and systemic toxicities. We conducted a literature search of published studies using HILP and ILI for the treatment of extremity sarcomas and melanomas, and associated toxicities was performed. The regional toxicities of HILP and ILI are similar. The most common toxicities reported are mild to moderate. However, when severe regional toxicity occurs, albeit infrequently (<5%), fasciotomies or even amputation may be necessary. Some studies have showed a relationship between acute regional toxicities and long term regional morbidity. Systemic toxicity appears to be more frequent when TNF-α is used in combination with other drugs during HILP, however the use of TNF-α in the United States is limited to trials. Although regional toxicities are similar, systemic toxicity of ILI is minimal compared to HILP. ILI is easier to repeat, technically less complex, and may be more acceptable in infirmed patients. Long term morbidity and outcomes for ILI are still being evaluated. Both of these techniques may be suitable options in patients with unresectable advanced or recurrent, or in transit extremity melanoma or sarcoma.

KW - Extremity melanoma and sarcoma

KW - Hyperthermic perfusion

KW - Limb infusion

KW - Regional and systemic toxicities

UR - http://www.scopus.com/inward/record.url?scp=42049104793&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42049104793&partnerID=8YFLogxK

U2 - 10.1080/02656730701805520

DO - 10.1080/02656730701805520

M3 - Article

VL - 24

SP - 275

EP - 289

JO - International Journal of Hyperthermia

JF - International Journal of Hyperthermia

SN - 0265-6736

IS - 3

ER -