Isolated Limb Infusion (ILI) with tumor necrosis factor (TNF) and melphalan was reported to be effective in treatment of locally advanced extremity malignancies. We developed the ILI with cisplatin for a phase II trial.
To investigate the role of ILI in treatment of locally advanced extremity malignancies.
The protocol was approved by IRB in Fudan University Shanghai Cancer Center. The patients were evaluated with MRI before ILI and were reviewed by multimodality treatment group which consistently agreed on unresectability. Treatment associated morbidities were recorded and the patient was evaluated 1 month after ILI, operated or followed up.
Three ILIs were performed on two patients, one with leiomyosarcoma in left proximal lateral calf had 1 ILI and the other with recurrent epithelioid sarcoma in forearm had 2 ILIs. Cisplatin of 120mg was used for the first patient and 60mg for the second. The first patient presented with lower extremity edema which lasted for 2 weeks and the second patient had a skin ulceration which healed 1 week later at first ILI. Both had no liver and renal function impairment, no hematologic toxicities and no extremity dysfunction. Re-evaluation with MRI indicated that the two patient had a response of PR to ILI and the first patient was then treated with conservative surgery, the second patient was routinely followed up. With a mean follow up of 6 months, no major complication and morbidities was found with ILI and the surgically treated patient had a fair functional results and the second patient had a stable disease.
Conclusions:Though only few cases enrolled, our study indicated that ILI with cisplatin could be an option for locally advanced malignancies especially in those with chemo-resistant sarcomas.