Lejeune F, Liénard D, Eggermont A, Schraffordt Koops H, Kroon B, Gérain J, Rosenkaimer F, Schmitz P
Centre Pluridisciplinaire d'Oncologie, CHUV, Lausanne, Switzerland.
Circ Shock. 1994 Aug;43(4):191-7.
Isolated perfusion of the limbs (ILP) allows the delivery of high dose rTNF alpha in a closed system with acceptable side-effects. A protocol with a triple-drug regimen was based on the reported synergism of rTNF alpha with chemotherapy, with interferon-gamma, and with hyperthermia. In melanoma-in-transit metastases (stage IIIA or AB) we obtained a 91% complete response compared with 52% after ILP with melphalan alone. Leakage and release of nanograms levels of TNF alpha in the systemic circulation can be abrogated in most patients by low pump flow, continuous leak monitoring, extensive washout, and limb massage. In case of unavoidable leakage, appropriate intensive care results in minimal toxicity. The ILP with rTNF alpha appears to be a useful model for studying the biochemotherapy of cancer in humans.
肢体隔离灌注（ILP）能够在副作用可接受的封闭系统中给予高剂量的重组肿瘤坏死因子α（rTNFα）。基于rTNFα与化疗、干扰素-γ以及热疗之间已报道的协同作用，制定了一种三联药物方案。在肢端转移黑色素瘤（IIIA期或AB期）患者中，我们观察到采用该方案的患者完全缓解率达91%，而单独使用美法仑进行ILP治疗的患者完全缓解率仅为52%。通过低泵流量、持续渗漏监测、充分冲洗以及肢体按摩，大多数患者可避免纳克水平的TNFα在体循环中的渗漏和释放。万一发生不可避免的渗漏，适当的重症监护可使毒性降至最低。含rTNFα的ILP似乎是研究人类癌症生物化疗的有用模型。
