Clinical Management and Current Research in Isolated Limb Perfusion for Sarcoma and Melanoma

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Abstract

Currently, isolated limb perfusion (ILP) attracts major interest in the treatment of soft tissue sarcoma and melanoma confined to the limb. The procedure combines innovative approaches such as hyperthermia, the use of cytokines, as well as the administration of high-dose chemotherapy. Although used since more than 40 years, the basic knowledge on the mode of action of ILP is still limited. Besides regional toxicity, systemic effects following the application of rhTNF in the perfusion circuit have to be taken into account. Furthermore, WHO criteria of tumor response are rarely met after perfusion of sarcomas. To overcome this, new modalities based on tumor metabolism are currently under investigation. Also the clinical decision on how to proceed after a successful ILP is discussed.

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Most cited references 8

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The neurosteroid tetrahydroprogesterone attenuates the endocrine response to stress and exerts glucocorticoid-like effects on vasopressin gene transcription in the rat hypothalamus.

O F X Almeida, V. Patchev, F Holsboer … (1996)

The neurosteroid tetrahydroprogesterone (5 alpha-pregnan-3 alpha-ol-20-one, allopregnanolone, THP), has been previously shown to counteract the anxiogenic effects of corticotropin-releasing hormone (CRH) and to interfere with noradrenergic and corticosteroid-mediated regulation of CRH release and gene transcription. Those observations indicated that, besides its sedative and analgesic activity, THP may also affect the neuroendocrine response to stress in a mode resembling that of corticosteroids. To examine this possibility, we compared the ability of THP, its precursor progesterone (P4), and the glucocorticoids dexamethasone (DEX) and corticosterone (CORT) to influence the pituitary-adrenal response to acute emotional stress and the adrenalectomy-induced increase in the gene transcription of the stress-related peptide arginine vasopressin (AVP) and of corticosteroid receptors (MR and GR) in the brain. Pretreatment of rats with a single dose of THP or P4 (50 micrograms/kg) significantly attenuated the elevation of plasma adrenocorticotropin (ACTH) and serum corticosterone after emotional stress; both steroids were, however, less potent than a similar dose of DEX. Administration of 1 mg of THP, CORT, or P4 to adrenalectomized (ADX) rats attenuated the increase in AVP mRNA levels in the ventromedial subdivision of the hypothalamic paraventricular nucleus (PVN), as compared with vehicle-treated ADX rats. However, whereas CORT and P4 influenced the ADX-induced increase in the transcription of both types of corticosteroid receptors in the hippocampus, these were unaffected by THP. In contrast to the glucocorticoids, THP and P4 failed to decrease plasma ACTH levels in rats deprived of endogenous steroids. These results demonstrate that the neurosteroid THP and its precursor P4 resemble glucocorticoids in their suppression of the pituitary-adrenal response to emotional stress; however, THP influences the transcription of glucocorticoid-responsive genes in brain structures involved in the regulation of the hypothalamo-pituitary-adrenal system in a fashion that is quite distinct from that obtained with glucocorticoids.

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Isolated Limb Perfusion with Tumor Necrosis Factor and Melphalan for Limb Salvage in 186 Patients with Locally Advanced Soft Tissue Extremity Sarcomas

Gur Ben-Ari, Ferdy J Lejeune, Jean-Claude Pector … (1996)

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Recombinant tumor necrosis factor: its effect and its synergism with interferon-γ on a variety of normal and transformed human cell lines

Lucie Fransen, José Van der Heyden, Roos Ruysschaert … (1986)

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Author and article information

Journal

Journal ID (publisher-id): OCL

Journal ID (nlm-ta): Oncology

Journal ID (doi): 10.1159/issn.0030-2414

Title: Oncology

Publisher: S. Karger AG

ISSN (Print): 0030-2414

ISSN (Electronic): 1423-0232

Publication date Subscription-year: 1998

Publication date (Print): April 1998

Publication date (Electronic): 30 January 1998

Volume: 55

Issue: 2

Pages: 89-102

Affiliations

Robert Rössle Hospital and Tumor Institute, Max Delbrück Center for Molecular Medicine, Virchow Klinikum, Humboldt University, Berlin, Germany

Article

Publisher ID: 11842 Other ID: Oncology 1998;55:89–102

DOI: 10.1159/000011842

PubMed ID: 9499194

SO-VID: ac360f7a-7634-4ba2-bead-ba94ad690181

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