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Perfusión de extremidad aislada en Oncología

Isolated limb perfusion in Oncology

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Resumen

La perfusión de extremidad aislada (PEA) con melfalán es activa en el tratamiento de las metástasis en tránsito de melanoma, pero no ha mostrado eficacia en el de sarcomas de partes blandas irresecables de extremidad. Esta situación se ha visto modificada con la aparición del factor de necrosis tumoral-α (TNF), fármaco que destruye la vasculatura tumoral y aumenta de tres a 6 veces la captación selectiva de otros medicamentos por el tumor. Actualmente está demostrado que la PEA con TNF más melfalán es una modalidad terapéutica muy exitosa en ambas indicaciones para prevenir la amputación del miembro afecto. También hay datos contrastados sobre la eficacia de este régimen en tumores cutáneos multifocales y sarcomas óseos refractarios.

Abstract

Isolated limb perfusion (ILP) with melphalan is effective in the treatment of in-transit metastasis from melanoma, but did not show activity against unresectable soft tissue sarcoma of the extremity. Tumor necrosis factor-α (TNF), a drug that destroys tumor vessels and enhances tumor-selective drug uptake by threefold to sixfold, has changed this situation. Nowadays, ILP with TNF and melphalan is a very well established therapeutic modality for both indications, to prevent limb amputation. There are also reported data on the success of this regimen against multifocal skin tumors, and drug-refractory bony sarcomas.

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Authors and Affiliations

  1. Departamento de Oncología, Hospital San Jaime, Torrevieja. Alicante, Spain

    Emiliano Calvo Aller & Antonio Brugarolas Masllorens

  2. Departamento de Cirugía Cardiovascular y Torácica, Hospital San Jaime, Torrevieja. Alicante, Spain

    Ramón Arcas Meca

  3. Departamento de Medicina Nuclear, Hospital San Jaime, Torrevieja. Alicante, Spain

    Aurora Crespo de la Jara

  4. Department of Surgical Oncology. Daniel den Hoed Cancer Center, Erasmus University Medical Center, Rotterdam, The Netherlands

    Timo LM ten Hagen & Alexander MM Eggermont

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  1. Emiliano Calvo Aller
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Aller, E.C., Meca, R.A., de la Jara, A.C. et al. Perfusión de extremidad aislada en Oncología. Rev Oncol 5, 128–138 (2003). https://doi.org/10.1007/BF02712847

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