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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
|
| pubmed:dateCreated |
1992-5-13
|
| pubmed:abstractText |
To increase the therapeutic efficacy of recombinant tumor necrosis factor alpha (rTNF alpha) and reduce the systemic side effects, a protocol was designed using isolation perfusion of the limbs with hyperthermia for in transit metastases of melanoma. A triple combination of high dose rTNF alpha + recombinant interferon-gamma (rIFN-gamma) + melphalan was chosen because of a synergistic anti-tumor effect of rTNF alpha with rIFN-gamma and of rTNF alpha with alkylating agents reported in the literature. Twenty-nine patients of mean age 60 years (range 22-82 years) entered the study after informed consent and received a total of 31 isolation perfusions with the triple combination. There were 24 women and 5 men with multiple progressive in transit melanoma metastases of the lower limb (stage IIIa or IIIab). rTNF alpha at the unique dose of 4 mg was injected as a bolus in the arterial line, under mild hyperthermic conditions (40 to 40.5 degrees C) for 90 minutes. rIFN-gamma was given subcutaneously on days -2 and -1 and in the perfusate, with rTNF alpha, at the dose of 0.2 mg. Melphalan was administered in the perfusate at dose giving a concentration of 40 micrograms/ml. In all the 31 isolation perfusions performed in the triple combination protocol, in order to prevent a septic shock-like syndrome which had been encountered in 2 patients treated outside this protocol for sarcoma and carcinoma, the patients received dopamine continuous infusion at 3 micrograms/kg/min from the start of isolation perfusion and for 48 hours, and only showed mild hypotension and very transient chills and temperature.(ABSTRACT TRUNCATED AT 250 WORDS)
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical | |
| pubmed:status |
MEDLINE
|
| pubmed:issn |
0364-2313
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
16
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
234-40
|
| pubmed:dateRevised |
2011-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:1561804-Adult,
pubmed-meshheading:1561804-Aged,
pubmed-meshheading:1561804-Aged, 80 and over,
pubmed-meshheading:1561804-Chemotherapy, Cancer, Regional Perfusion,
pubmed-meshheading:1561804-Dopamine,
pubmed-meshheading:1561804-Female,
pubmed-meshheading:1561804-Follow-Up Studies,
pubmed-meshheading:1561804-Humans,
pubmed-meshheading:1561804-Hyperthermia, Induced,
pubmed-meshheading:1561804-Interferon-gamma,
pubmed-meshheading:1561804-Lymphatic Metastasis,
pubmed-meshheading:1561804-Male,
pubmed-meshheading:1561804-Melanoma,
pubmed-meshheading:1561804-Melphalan,
pubmed-meshheading:1561804-Middle Aged,
pubmed-meshheading:1561804-Neoplasm Staging,
pubmed-meshheading:1561804-Recombinant Proteins,
pubmed-meshheading:1561804-Remission Induction,
pubmed-meshheading:1561804-Shock,
pubmed-meshheading:1561804-Skin Neoplasms,
pubmed-meshheading:1561804-Tumor Necrosis Factor-alpha
|
| pubmed:articleTitle |
In transit metastases of malignant melanoma treated by high dose rTNF alpha in combination with interferon-gamma and melphalan in isolation perfusion.
|
| pubmed:affiliation |
Department of Surgery, Jules Bordet Institute, Université Libre de Bruxelles, Belgium.
|
| pubmed:publicationType |
Journal Article,
Research Support, Non-U.S. Gov't
|