Rationale for different approaches to combined melphalan and hyperthermia in regional isolated perfusion

被引:13
作者
vanderZee, J
Kroon, BBR
Nieweg, OE
vandeMerwe, SA
Kampinga, HH
机构
[1] NETHERLANDS CANC INST,DEPT SURG,AMSTERDAM,NETHERLANDS
[2] UNIV GRONINGEN,DEPT RADIOBIOL,GRONINGEN,NETHERLANDS
关键词
hyperthermia; malignant melanoma; melphalan; regional isolated perfusion;
D O I
10.1016/S0959-8049(97)00116-0
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The addition of hyperthermia (HT) to regional isolated perfusion (RIP) with Melphalan theoretically has two advantages. Firstly, heat can selectively kill cells in poorly vascularised areas that are usually not reached by the drug. Secondly, in vitro data have revealed that the effect of Melphalan is enhanced at temperatures 39-45 degrees C. However, for the simultaneous application of Melphalan and HT, as it is given in most institutes, both normal and tumour tissues within the volume are treated with both modalities. It is unclear whether-for the same heat dose-the cytoxicity of Melphalan is enhanced more in tumour tissue than in normal tissues. As the applied dose of Melphalan in RIP is selected on maximum acceptable toxicity, any enhancement of toxicity is undesired. Indeed, Melphalan application at temperatures >41 degrees C has resulted in unacceptable toxicity. In most institutes, the hyperthermia dose is reduced in comparison to application as a single-modality treatment, to allow simultaneous combination without unacceptable toxicity. In this review, the rationale for two different approaches is summarised which may make it possible to improve the benefit from the theoretical advantage of the use of HT in RIP. It is meant to stimulate discussion as a possible first step in the design of new treatment protocols. (C) 1997 Elsevier Science Ltd.
引用
收藏
页码:1546 / 1550
页数:5
相关论文
共 39 条
[11]   THERMOCHEMOTHERAPY WITH CIS-PLATINUM, CCNU, BCNU, CHLORAMBUCIL AND MELPHALAN ON MURINE MARROW AND 2 TUMORS - THERAPEUTIC GAIN FOR MELPHALAN ONLY [J].
HONESS, DJ ;
BLEEHEN, NM .
BRITISH JOURNAL OF RADIOLOGY, 1985, 58 (685) :63-72
[12]   ULTRASTRUCTURAL-CHANGES IN THE RAT SCIATIC-NERVE AFTER LOCAL HYPERTHERMIA [J].
HOOGEVEEN, JF ;
TROOST, D ;
VANDERKRACHT, AHW ;
WONDERGEM, J ;
HAVEMAN, J ;
GONZALEZ, DG .
INTERNATIONAL JOURNAL OF HYPERTHERMIA, 1993, 9 (05) :723-730
[13]  
*INT COLL HYP GROU, 1996, INT J RADIAT ONCOL, V35, P731
[14]   PATIENT-RELATED AND TREATMENT-RELATED FACTORS ASSOCIATED WITH ACUTE REGIONAL TOXICITY AFTER ISOLATED PERFUSION FOR MELANOMA OF THE EXTREMITIES [J].
KLAASE, JM ;
KROON, BBR ;
VANGEEL, BN ;
EGGERMONT, AMM ;
FRANKLIN, HR ;
HART, GAM .
AMERICAN JOURNAL OF SURGERY, 1994, 167 (06) :618-620
[15]   A RETROSPECTIVE COMPARATIVE-STUDY EVALUATING THE RESULTS OF MILD HYPERTHERMIC VERSUS CONTROLLED NORMOTHERMIC PERFUSION FOR RECURRENT MELANOMA OF THE EXTREMITIES [J].
KLAASE, JM ;
KROON, BBR ;
EGGERMONT, AMM ;
VANGEEL, AN ;
KOOPS, HS ;
OLDHOFF, J ;
LIENARD, D ;
LEJEUNE, FJ ;
BERKEL, R ;
FRANKLIN, HR ;
HART, AAM .
EUROPEAN JOURNAL OF CANCER, 1995, 31A (01) :58-63
[16]  
Kroon B, 1992, REGIONAL CANCER TREA, P223
[17]  
KROON BBR, 1987, ANTICANCER RES, V7, P441
[18]   RESULTS OF A DOUBLE PERFUSION SCHEDULE WITH MELPHALAN IN PATIENTS WITH MELANOMA OF THE LOWER-LIMB [J].
KROON, BBR ;
KLAASE, JM ;
VANGEEL, BN ;
EGGERMONT, AMM ;
FRANKLIN, HR ;
VANDONGEN, JA .
EUROPEAN JOURNAL OF CANCER, 1993, 29A (03) :325-328
[19]  
KROON BBR, 1992, REG CANCER TREAT, V4, P305
[20]  
LAW MP, 1978, BRIT J RADIOL, V51, P132, DOI 10.1259/0007-1285-51-602-132