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Isolation perfusion of the lower limb with platinum

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Abstract

From August, 1983 to February, 1986, a total of 14 patients affected by osteogenic sarcoma of the limbs have been treated at the National Cancer Institute, Milan, Italy. For all patients, due to the size of tumor and the extracompartmental invasion, the only possible treatment was an amputation or disarticulation and, for this reason, it was decided to submit the patients to combined treatments according to this schedule: 2 subsequent intraarterial infusions of cis-platinum (CDDP) + systemic high-dose methotrexate (MTX), followed by hyperthermic antiblastic perfusion in extracorporeal circulation and 2 more cycles of systemic high-dose MTX + CDDP.

This schedule of treatment is reasonably well tolerated by the patients, despite the side effects and the length of the entire presurgical period. No significant complications have been observed, either local or systemic.

Résumé

Du mois d'août 1983 au mois de février 1986, 14 malades présentant un sarcome ostéogénique des membres ont été traités à l'Institut National du Cancer de Milan (Italie). Chez tous ces malades en raison du volume de la tumeur et de son extension le seul traitement possible fut l'amputation ou la désarticulation. L'intervention fut précédée de 2 transfusions intra-artérielles consécutives de Cis-platinum (CDPP) et de l'administration par voie générale de fortes doses de méthotrexate (MTX), ces 2 épisodes furent suivis d'une transfusion de sang hyperthermique réchauffé par circulation extra-corporelle et de 2 nouveaux cycles de chimiothérapie associant CDDP et MTX.

Ce traitement fut généralement assez bien toléré par les malades malgré les effets secondaires et la durée du traitement pré-opératoire. Aucune complication, locale ou générale, ne fut observée.

Resumen

Catorce pacientes con sarcoma osteogénico de las extremidades fueron tratados en el Institute de Cancer de Milán, Italia, entre agosto de 1983 y febrero de 1986. En la totalidad de los pacientes, por razón del volúmen del tumor y la invasión extracompartimental, la única modalidad posible de tratamiento era amputación o la desarticulación, y por ello se decidió someterlos a terapia combinada de acuerdo al siguiente programa: 2 infusiones intraarteriales subsecuentes de Cisplatino (CDDP) + metotrexato sistémico en alta dosis (MTX), seguidos de perfusión hipertérmica antiblástica mediante circulación extracorpórea y 2 ciclos adicionales de MTX sistémico en alta dosis + CDDP.

En general, este programa terapéutico es razonablemente bien tolerado por el paciente, a pesar de los efectos colaterales y lo extenso del período prequirúrgico. No se han observado complicaciones significativas, ni del tipo local ni sistémico.

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Authors and Affiliations

  1. Department of Surgical Oncology “B”, National Cancer Institute, Via Venezian 1, 20133, Milan, Italy

    M. Vaglini M.D., F. Belli M.D. & M. Santinami M.D.

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  1. M. Vaglini M.D.
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  2. F. Belli M.D.
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  3. M. Santinami M.D.
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Partially supported by grant no. 85.02401.44 of the National Research Council.

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Vaglini, M., Belli, F. & Santinami, M. Isolation perfusion of the lower limb with platinum. World J. Surg. 12, 307–309 (1988). https://doi.org/10.1007/BF01655662

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