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Br J Cancer. 2015 Aug 11;113(4):645-52. doi: 10.1038/bjc.2015.246. Epub 2015 Jul 14.

TNF-alpha and melphalan-based isolated limb perfusion: no evidence supporting the early destruction of tumour vasculature.

Author information

1
Section for Sarcoma Surgery, Department of General, Visceral and Transplantation Surgery, University Hospital of Essen and Sarcoma Center at the West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, D-45122 Essen, Germany.
2
Institut für Physiologische Chemie, Universitätsklinikum Essen, Hufelandstrasse 55, D-45122 Essen, Germany.
3
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital of Essen and Sarcoma Center at the West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, D-45122 Essen, Germany.
4
Zentrum fuer Pathologie Essen-Mitte, ZPEM, Am Deimelsberg 34a, D-45276 Essen, Germany.

Abstract

BACKGROUND:

Isolated limb perfusion with TNF-alpha and melphalan (TM-ILP) is a highly effective treatment for locally advanced tumours of the extremities. Previous research suggests an almost immediate disintegration of the blood supply of the tumour. The aim of the present study was to verify this hypothesis using non-invasive measurements of microvascular perfusion and tissue oxygenation.

METHODS:

A total of 11 patients were included in the study. TM-ILP was performed under mildly hyperthermic conditions (39 °C) in the extremities via proximal vascular access. Capillary-venous microvascular blood flow, haemoglobin level (Hb) and oxygen saturation (SO2) were determined using laser Doppler and white-light spectroscopy, respectively, before TM-ILP and at 30 min, 4 h, 1 day, 4 days, 1 week, 2 weeks and 6 weeks after TM-ILP from tumour and healthy muscle tissues.

RESULTS:

Blood flow and Hb were mostly higher, whereas SO2 was lower, in tumour tissue compared with muscle tissue. In both tumour and muscle tissues, blood flow significantly increased immediately after TM-ILP and remained elevated for at least 2 weeks, followed by a return to the initial values 6 weeks after the procedure.

CONCLUSION:

No signs were found of early destruction of the tumour vasculature. The observations suggest that an inflammatory reaction is one of the key elements of TM-ILP.

PMID:
26171939
PMCID:
PMC4647687
DOI:
10.1038/bjc.2015.246
[Indexed for MEDLINE]
Free PMC Article

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