Lejeune F, Liénard D, Eggermont A, Schraffordt Koops H, Rosenkaimer F, Gérain J, Klaase J, Kroon B, Schmitz P
Centre pluridisciplinaire d'oncologie, CHUV, Lausanne, Suisse.
Bull Cancer. 1995 Jul;82(7):561-7.
The authors review their experience of 4 years with isolated limb perfusion for the application of high dose TNF-alpha associated to IFN-gamma and melphalan for the treatment of regionally advanced tumours such as malignant melanoma, soft tissue sarcoma and epidermoid carcinoma. In malignant melanoma, the complete remission rate reaches 91%. In irresectable soft tissue sarcoma, this treatment when used as a neoadjuvant treatment saves the limb from amputation in 87.5% of the cases. Similar results are obtained for epidermoid carcinoma. With the regional application of high doses of TNF-alpha associated to chemotherapy and IFN-gamma, it has been possible to validate the concept of a strategy based on a dual targeting, that is the selective impact of the intratumoral vessels by TNF-alpha and of the tumour cells by chemotherapy. This approach appears to be the treatment of choice for locally advanced tumours of the limbs. However, as a single therapy, this procedure should be considered in melanoma as an induction therapy, and in sarcoma, as a preoperative treatment.
作者回顾了他们4年来使用隔离肢体灌注法的经验，即将高剂量肿瘤坏死因子-α（TNF-α）联合干扰素-γ（IFN-γ）及美法仑用于治疗局部晚期肿瘤，如恶性黑色素瘤、软组织肉瘤和表皮样癌。在恶性黑色素瘤中，完全缓解率达91%。在无法切除的软组织肉瘤中，该治疗作为新辅助治疗时，87.5%的病例可避免肢体截肢。表皮样癌也取得了类似结果。通过高剂量TNF-α联合化疗及IFN-γ的局部应用，已证实了基于双重靶向的治疗策略概念，即TNF-α对肿瘤内血管的选择性作用以及化疗对肿瘤细胞的作用。这种方法似乎是肢体局部晚期肿瘤的首选治疗方法。然而，作为单一疗法，在黑色素瘤中该程序应被视为诱导疗法，在肉瘤中则应作为术前治疗。
