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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4 Suppl
pubmed:dateCreated
2006-6-13
pubmed:abstractText
Hyperthermic antiblastic perfusion/HAP) has been proven to be an effective neoadjuvant treatment in the treatment of advanced soft tissue limb sarcoma. As a matter of fact high percentage of limb sparing surgery, local control and functional results have been obtained wide this technique. Many antineoplastic drugs have been associated to hyperthermia by isolation limb perfusion, the aim of this paper was to describe the results obtained with doxorubicin in association to hyperthermia with or without Tumor Necrosis Factor (TNF) alpha in order to identify the most effective regimen in the multidisciplinary treatment of soft tissue limb sarcoma. A total of 106 patients have been evaluated. Three different study were performed: the first was a phase I study carried out in order to assess the maximum tolerable dose (MTD) of doxorubicin during HAP; the second was a phase II study with doxorubicin, and the third was a phase I - II study aimed at evaluating the MTD and tumor response of TNF alpha in association to doxorubicin and hyperthermia. Grade IV limb toxicity was recorded in 11 patients ( 4 in trial A, 3 in trial B, and 4 in trial C). The grade of limb reaction was strictly related to TNF dosage (> 1 mg) and temperature level (> 41.5 degrees C), therefore the best regimen is represented by temperature level not exceeding 41.5 degrees C and 1 mg of TNFalpha. The trimodality association (TNF, doxorubicin and hyperthermia) was proven to be the best regimen able to obtain a 77% of objective response (complete response, 22%) and a 77% of limb sparing in patients candidate to amputation. The results above mentioned showed the HAP with doxorubicin and TNFalpha (1 mg) is a very effective neoadjuvant treatment in the multidisciplinary treatment of advanced soft tissue limb sarcoma.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
0392-9078
pubmed:author
pubmed:issnType
Print
pubmed:volume
22
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
81-7
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:16767912-Adolescent, pubmed-meshheading:16767912-Adult, pubmed-meshheading:16767912-Aged, pubmed-meshheading:16767912-Antibiotics, Antineoplastic, pubmed-meshheading:16767912-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:16767912-Chemotherapy, Cancer, Regional Perfusion, pubmed-meshheading:16767912-Disease-Free Survival, pubmed-meshheading:16767912-Dose-Response Relationship, Drug, pubmed-meshheading:16767912-Doxorubicin, pubmed-meshheading:16767912-Extremities, pubmed-meshheading:16767912-Female, pubmed-meshheading:16767912-Humans, pubmed-meshheading:16767912-Hyperthermia, Induced, pubmed-meshheading:16767912-Male, pubmed-meshheading:16767912-Maximum Tolerated Dose, pubmed-meshheading:16767912-Middle Aged, pubmed-meshheading:16767912-Neoadjuvant Therapy, pubmed-meshheading:16767912-Sarcoma, pubmed-meshheading:16767912-Sex Factors, pubmed-meshheading:16767912-Soft Tissue Neoplasms, pubmed-meshheading:16767912-Tumor Necrosis Factor-alpha
pubmed:year
2003
pubmed:articleTitle
Doxorubicin in isolation limb perfusion in the treatment of advanced limb soft tissue sarcoma.
pubmed:affiliation
Department of Surgery, Regina Elena National Cancer Institute, Rome Italy. difilippo@ifo.it
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't, Multicenter Study, Clinical Trial, Phase II, Clinical Trial, Phase I