Radionuclide leakage monitoring during hyperthermic isolated limb perfusion for treatment of local melanoma metastasis in an extremity. (5th June 2014)

• Record Type: Journal Article
• Authors: Paulsen, Ida F.; Chakera, Annette Hougaard; Schmidt, Grethe; Drejøe, Jennifer; Klyver, Helle; Oturai, Peter S.; Hesse, Birger; Drzewiecki, Krystztof; Mortensen, Jann
• Is Part Of: Clinical physiology and functional imaging. Volume 35:Number 4(2015:Jul.)
• Page Start: 301
• Page End: 305
• Publication Date: 2014-06-05
• Subjects: Physiology, Pathological -- Periodicals; Diagnostic imaging -- Periodicals; 612
• DOI: 10.1111/cpf.12164
• Languages: English
• ISSNs: 1475-0961

Abstract

<abstract abstract-type="main" id="cpf12164-abs-0001"> <title>Summary</title> <sec id="cpf12164-sec-0001" sec-type="section"> <title>Introduction</title> <p>The aim is to describe the importance of leakage monitoring in hyperthermic isolated limb perfusion (ILP). It is generally recommended that leakage should not exceed 10% because of risk of systemic toxicity.</p> </sec> <sec id="cpf12164-sec-0002" sec-type="section"> <title>Material and methods</title> <p>Data retrieved by retrospective analysis of 131 perfusions performed in 115 consecutive patients (77 women and 38 men; median age 66 years) with recurrent and/or clinically apparent, cutaneous or subcutaneous melanoma metastases in an extremity. Radionuclide monitoring was performed with continuous, precordial count rate determinations of an intravascular <sup>99m</sup>Tc‐labelled tracer infused into the isolated limb circulation.</p> </sec> <sec id="cpf12164-sec-0003" sec-type="section"> <title>Results</title> <p>One hundred and sixteen of 131 procedures were completed. In 13%, a leakage of ≥10% was detected; in 6% (<italic>n </italic>=<italic> </italic>8), the cytotoxic drug was never infused because of constant leakage; in 7% (<italic>n </italic>=<italic> </italic>9), leakage ≥10% was measured during the perfusion resulting in two perfusions being terminated before 30 min, 5 perfusions were considered completed though with early termination (after 30 min, before 60 min), and 2 fully completed. No patients had systemic toxicity requiring treatment, whereas considerable or serious local toxicity were observed in 14%. Three of the patients with leakage ≥10% were successfully treated in a repeated procedure.</p> </sec> <sec id="cpf12164-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Leakage monitoring using a threshold of 10% during ILP saves the patients from systemic toxicity, however, at the expense of early termination or cancellation of ILP treatment in a few patients and repeated ILP procedures in some.</p> </sec> </abstract>