Pre- and Perioperative Perfusion Chemotherapy for Soft Tissue Sarcoma of the Limbs

  • Michael Meyer
  • James H. Muchmore
  • Edward T. Krementz
Part of the Cancer Treatment and Research book series (CTAR, volume 56)


Soft tissue sarcomas are relatively rare tumors. Each year in the U.S., there are approximately 5,500 new cases and 2,900 deaths attributed to these tumors [1,2]. Approximately 60% of these tumors develop in the extremities.


Soft Tissue Sarcoma Local Recurrence Rate Synovial Sarcoma Limb Salvage Wide Excision 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    McClay EF: Epidemiology of bone and soft tissue sarcomas. Semin Oncol 16(4):254–272.Google Scholar
  2. 2.
    Silverberg E, Lubera JA: Cancer statistics. Cancer 38:14–15, 1988.Google Scholar
  3. 3.
    Cadman J, Soule FH, Kelly PJ: Synovial sarcomas: An analysis of 134 tumors. Cancer 18:613–627, 1965.PubMedCrossRefGoogle Scholar
  4. 4.
    Shieber W, Graham P: An experience with sarcoma of the soft tissues in adults. Surgery 52:295–298, 1962.PubMedGoogle Scholar
  5. 5.
    Castro EB, Hajdu SI, Fortner JG: Surgical therapy of fibrosarcoma of extremities. Arch Surg 107:284–291, 1973.PubMedCrossRefGoogle Scholar
  6. 6.
    Shiu MH, Castro EB, Hajdu SI, Fortner JG: Surgical treatment of 297 soft tissue sarcomas of the lower extremity. Ann Surg 182:597–602, 1975.PubMedCrossRefGoogle Scholar
  7. 7.
    Cautin J, McNeer GP, Chu FC, Booker RJ: The problem of local recurrence after treatment of soft tissue sarcoma. Ann Surg 168:47–53, 1968.CrossRefGoogle Scholar
  8. 8.
    Simon MA, Spanier SS, Euneking WF: Management of adult soft tissue sarcomas of the extremities. Ann Surg 11:363–402, 1979.Google Scholar
  9. 9.
    Klopp CT, Alford TC, Bateman J, et al.: Fractionated intra-arterial cancer chemotherapy with bis-amine hydrochloride; a preliminary report. Ann Surg 132:811–832, 1950.PubMedCrossRefGoogle Scholar
  10. 10.
    Bierman HR, Byron RL, Jr, Kelly KH: Therapy of inoperable visceral and regional metastasis by intra-arterial catheterization in man. Cancer Res 11:236, 1951.Google Scholar
  11. 11.
    Creech OJ, Krementz ET, Ryan RT, Winblad JN: Chemotherapy of cancer: Regional perfusion utilizing an extracorporeal circuit. Ann Surg 148:616–632, 1958.PubMedCrossRefGoogle Scholar
  12. 12.
    Krementz ET: Regional perfusion: Current sophistication, what next? Cancer 57(3):416 430, 1986.PubMedCrossRefGoogle Scholar
  13. 13.
    Krementz ET, Carter RD, Sutherland CM, Hutton IM: Chemotherapy of sarcomas of the limbs by regional perfusion. Ann Surg 185(5), 1977.Google Scholar
  14. 14.
    Krementz ET, Muchmore JH: Soft tissue sarcomas: Behavior and management. Adv Surg 16:147–196, 1983.PubMedGoogle Scholar
  15. 15.
    Carter RD, Faddis DM, Krementz ET, Salwen WA, Puyau FA, Muchmore JH: Treatment of locally advanced breast cancer with regional intra-arterial chemotherapy. Reg Cancer Treat 1:108–111, 1988.Google Scholar
  16. 16.
    Kaulheim G, Gundersen S, Hager B, et al.: Intra-arterial infusion of mitomycin-C in treatment of breast cancer: Occurrence of skin necrosis in irradiated patients. Radiother Oncol 4:127–132, 1985.CrossRefGoogle Scholar
  17. 17.
    Auersperg M, Furlan L, Marolt F, et al.: Intra-arterial chemotherapy and radiotherapy in locally advanced cancer of the oral cavity and oropharynx. Int J Radiat Oncol Biol Phys 4:273–277, 1978.PubMedCrossRefGoogle Scholar
  18. 18.
    Huberman MG: Comparison of systemic chemotherapy with hepatic arterial infusion in metastatic colorectal carcinoma. Semin Oncol 10:238–248, 1983.PubMedGoogle Scholar
  19. 19.
    Oberfield RA: Intra-arterial hepatic infusion chemotherapy in metastatic liver cancer. Semin Oncol 10:206–214, 1983.PubMedGoogle Scholar
  20. 20.
    Kemeny N, Daly J, Reichman B, et al.: Intrahepatic or systemic infusion of fluorodeoxyuri-dine in patients with liver metastases from colorectal carcinoma. Ann Intern Med 107:459–465, 1987.PubMedGoogle Scholar
  21. 21.
    Eapen L, Stewart D, Danjoux C, et al.: Intra-arterial cisplatin and concurrent radiation for locally advanced bladder cancer. J Clin Oncol 7:230–235, 1989.PubMedGoogle Scholar
  22. 22.
    Shipley WU, Prout GR, Einstein AB, et al.: Treatment of invasive bladder cancer by cisplatin and radiation in patients unsuited for surgery. JAMA 258:931–935, 1987.PubMedCrossRefGoogle Scholar
  23. 23.
    Eilber FR, Guiliano AE, Huth J, Mirra J, Morton DL: Limb salvage for high-grade soft tissue sarcomas of the extremity: Experience at the University of California, Los Angeles. Cancer Treat Symp 3:49–57, 1985.Google Scholar
  24. 24.
    Mantravadi RV, Trippon MJ, Patel MS, Walker MJ, Das Gupta TK: Limb salvage in extremity soft-tissue sarcoma: Combined modality therapy. Radiology 152:523–526, 1984.PubMedGoogle Scholar
  25. 25.
    Denton JW, Dunham WK, Salter M, Urist NM, Balch CM: Pre-operative regional chemotherapy and rapid-fraction irradiation for sarcomas of the soft tissue and bone. Surg Gynecol Obstet 158:545–551, 1984.PubMedGoogle Scholar
  26. 26.
    Goodnight JE, Bargar WL, Voegeli T, Blaisdell FW: Limb-sparing surgery for extremity sarcomas after pre-operative intra-arterial doxorubicin and radiation therapy. Am J Surg 150:109–113, 1985.PubMedCrossRefGoogle Scholar
  27. 27.
    Stephens FO, Tattersall MHN, Marsden W, Waugh RC, Green D, McCarthy SW: Regional chemotherapy with the use of cisplatin and doxorubicin as primary treatment for advanced sarcomas in shoulder, pelvis, and thigh. Cancer 60:724–735, 1987.PubMedCrossRefGoogle Scholar
  28. 28.
    Hoekstra HJ, Heimen SK, Molenaar WM, Oldhoff J: Results of isolated perfusion of malignant soft tissue tumors of the extremities. Cancer 60:1703–1707, 1987.PubMedCrossRefGoogle Scholar
  29. 29.
    Azzarelli A, Gennari L, Quaglivlo V: Intra-arterial chemotherapy for soft tissue sarcoma of the extremities in management of soft tissue and bone sarcomas. In: Management of soft tissue tumors and bone sarcoma. Van Unnik JA, Van Oosterom AT (eds). New York: Raven Press, 1986.Google Scholar
  30. 30.
    Collins JM: Pharmacologic rationale for regional drug deliver. J Clin Oncol 2:498–504, 1984.PubMedGoogle Scholar
  31. 31.
    Ensminger WD, Gyves JW: Clinical pharmacology of hepatic arterial chemotherapy. Semin Oncol 10:176–182, 1983.PubMedGoogle Scholar
  32. 32.
    Steward DJ, Benjamin RS, Zimmerman S, et al.: Clinical pharmacology of intra-arterial cis-diamminedichloroplatinum (II). Cancer Res 43:917–920, 1983.Google Scholar
  33. 33.
    Garnick MB, Ensminger WD, Israel M: A clinical-pharmacological evaluation of hepatic arterial infusion of adriamycin. Cancer Res 39:4105–4110, 1979.PubMedGoogle Scholar
  34. 34.
    Gyves JW, Stetson P, Ensminger WD, et al.: Hepatic arterial streptozotocin: A clinical pharmacologic study in patients with liver tumors. Cancer Drug Deliv 1:63–66, 1983.PubMedCrossRefGoogle Scholar
  35. 35.
    Stewart DJ, Mikhael NZ, Nair RC, et al.: Platinum concentrations in human autopsy tumor samples. Am J Clin Oncol (CCT) 11:152–158, 1988.CrossRefGoogle Scholar
  36. 36.
    Levin VA, Kabra PM, Freeman-Dove MA: Pharmacokinetics of intracarotid artery 14C-BCNU in the squirrel monkey. J Neurosurg 48:587–593, 1978.PubMedCrossRefGoogle Scholar
  37. 37.
    Didolkar MS, Kanter PM, Baffi RR, et al.: Comparison of regional versus systemic chemotherapy with adriamycin. Ann Surg 187:332–336, 1978.PubMedCrossRefGoogle Scholar
  38. 38.
    Anderson LL, Collings GJ, Ojima Y, et al.: A study of the distribution of methotrexate in human tissues and tumors. Cancer Res 30:1344–1348, 1970.PubMedGoogle Scholar
  39. 39.
    Erjavea M, Auersperg M, Jez T: Quantitation of 99mTC bleomycin uptake in head and neck tumors. IRCS (J) Med Sci 2:1560, 1974.Google Scholar
  40. 40.
    Savaraj N, Lu K, Feun LG, et al.: Comparison of CNS penetration, tissue distribution, and pharmacology of VP16-213 by intracarotid and intravenous administration in dogs. Cancer Invest 5:11–16, 1987.PubMedCrossRefGoogle Scholar
  41. 41.
    Wallace S, Chuang VP, Carrasco H, et al.: Physioanatomic concepts and radiologie techniques for intra-arterial delivery of therapeutic agents. Cancer Bull 36:6–14, 1984.Google Scholar
  42. 42.
    Muchmore JH, Carter RD, Krementz ET: Regional perfusion for malignant melanoma and soft tissue sarcoma: A review. Cancer Invest 3(2):129–143, 1985.PubMedCrossRefGoogle Scholar
  43. 43.
    Cavaliere R, Calabro A, DiFillippo F, Carlini S, Giannavelli D: Prognostic parameters in limb recurrent melanoma treated with hyperthermic antiblastic perfusion. Conference on Advances in Regional Cancer Therapy, Vim, Federal Republic of German, G7 (Abstr) : 163, 1987.Google Scholar
  44. 44.
    Stehlin JS, Greeff PJ, deIpolyi PD, Giovanella BC, Klein G, McGaff CJ, Jr, Davis B, Williams U, Natelson EA, Anderson RF: Heat as an adjuvant in the treatment of advanced melanoma. An immune stimulant? Houston Med J 4:61, 1988.Google Scholar
  45. 45.
    Flaherty JH, Weisfeldt ML: Reperfusion injury. Free Radic Bioi Med 5:409-419, 1988.PubMedCrossRefGoogle Scholar
  46. 46.
    Krementz ET, Ryan RF, Muchmore JH, Carter RD, Sutherland CM, Reed RJ: Hyperthermic regional perfusion for melanoma of the limbs. In: Cutaneous melanoma, clinical management and treatment . Balch CM, Milton G (eds). Philadelphia: JB Lippincott, in press.Google Scholar

Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • Michael Meyer
  • James H. Muchmore
  • Edward T. Krementz

There are no affiliations available

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