The authors review their experience of 4 years with isolated limb perfusion for the application of high dose TNF-α associated to IFN-γ 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-α associated to chemotherapy and IFN-γ, 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-α 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.

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Bulletin du Cancer
Department of Surgery

Lejeune, F., Liénard, D., Eggermont, A., Schraffordt Koops, H., Rosenkaimer, F., Gérain, J., … Schmitz, P. (1995). Efficacy of tumour necrosis factor-alpha (rTNF-α) associated to interferon-gamma (IFN-γ) and to chemotherapy in isolated limb perfusion for inoperable malignant melanoma, soft tissue sarcoma and epidermoid carcinoma: a 4 year experience. Bulletin du Cancer, 82(7), 561–567. doi:10.1016/0007-4551(96)89993-0