The aim of this study was to assess the results of an isolated limb perfusion (ILP) schedule with high dose hyperthermia (42-43°C) and melphalan, applied sequentially in patients with advanced melanoma of the limbs. Seventeen patients with extensive recurrent or bulky melanoma of a limb were treated with hyperthermic femoral ILP (42-43°C) without drugs followed by normothermic (37-38°C) ILP with melphalan. Eleven patients (65%) had a complete response. Three patients (27%) had limb recurrences after 5, 6 and 18 months, respectively. The 5 year limb recurrence-free interval for patients with a complete response was 63%. Limb toxicity was mild; pressure-related blistering and transient sensory disturbances occurred after the hyperthermic ILP, and 88% of the patients had a grade II reaction (mild erythema and oedema) after the second ILP. This sequential ILP schedule resulted in a high complete response rate and a low limb-recurrence rate in patients with extensive, recurrent melanoma of the limbs at the cost of only mild toxicity. This regimen could be an alternative to ILP with tumour necrosis factor-α and melphalan.

Chemotherapy, Drug toxicity, Induced hyperthermia, Melanoma, Regional perfusion,
Melanoma Research: a journal for basic, translational and clinical research in melanoma
Department of Radiation Oncology

Noorda, E.M, Vrouenraets, B.C, Nieweg, O.E, Klaase, J.M, van der Zee, J, & Kroon, B.B.R. (2003). Long-term results of a double perfusion schedule using high dose hyperthermia and melphalan sequentially in extensive melanoma of the lower limb. Melanoma Research: a journal for basic, translational and clinical research in melanoma, 13(4), 395–399. doi:10.1097/00008390-200308000-00009