Faculty Collaboration Database

The use of isolated limb infusion in limb threatening extremity sarcomas. Int J Hyperthermia 2013;29(1):1-7

Date

12/05/2012

Pubmed ID

23205633

Pubmed Central ID

PMC4509503

DOI

10.3109/02656736.2012.740548

Scopus ID

2-s2.0-84872309033 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

UNLABELLED: This paper reports a single-institution experience with the use of isolated limb infusion for limb salvage in locally advanced, unresectable, recurrent limb threatening soft tissue sarcomas.

BACKGROUND: Locally advanced, limb threatening soft tissue sarcomas (STS) pose a significant treatment challenge. We report our experience using isolated limb infusion (ILI) in patients with unresectable extremity STS.

METHODS: A total of 22 patients with extremity STS underwent 26 ILIs with melphalan and dactinomycin. Patient characteristics, intra-operative parameters and toxicity were recorded. Outcome measures included limb-salvage and in-field response rates.

RESULTS: Of the 19 lower and 7 upper extremity ILIs, Wieberdink grade III toxicity or less was observed in all. Median followup was 11 months. A total of 17 patients were evaluable at 3 months post-ILI with an overall response rate of 42%. Four (24%) had complete response (CR), three (18%) partial response (PR), three (18%) stable disease (SD) and seven (41%) progressive disease (PD). Twelve of 17 (71%) underwent successful limb preservation at a median of 9 months post-ILI. Two (12%) were downstaged to resectable disease and remain showing no evidence of disease (NED) after surgery at 30 and 22 months post-ILI.

CONCLUSIONS: ILI is an attractive modality that provides regional disease control and limb preservation in patients with limb threatening sarcoma. Although short-term results appear encouraging, long-term follow-up is needed to fully assess the role of ILI in unresectable extremity STS.

Author List

Vohra NA, Turaga KK, Gonzalez RJ, Conley A, Reed D, Bui MM, Cheong D, Letson DG, Zager JS

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Antibiotics, Antineoplastic
Antineoplastic Agents, Alkylating
Antineoplastic Combined Chemotherapy Protocols
Chemotherapy, Cancer, Regional Perfusion
Dactinomycin
Extremities
Female
Humans
Male
Melphalan
Middle Aged
Sarcoma
Soft Tissue Neoplasms
Young Adult