Perfusao antiblástica hipertérmica regional no melanoma de membros em adultos / Regional hyperthermic antiblastic perfusion in extremities melanoma in adults

RESUMO

The first antiblastic regional perfusion was performed in 1957, in New Orleans, to treat a patient with locally advanced melanoma. This technique allows to use high doses of antiblastic drugs and was improved about 10 years later by additional hyperthermia, an idea suggested by Cavaliere et al and by Stehlin. Three types of isolated perfusion are possible normothermic antiblastic perfusion. The use of adjuvant hyperthermic antiblastic perfusion offers to patients with extremity melanomas an excellent chance of cure. To patients with ® in transit ¼ metastases, hyperthermic antiblastic perfusion offers the most effective treatment with limb salvage. The main complication in isolated perfusion is the escape of the perfusate to the systemic circulation, but methods for escape evaluation are improving with the utilization of radiolabelled serum albumin and gamma-detecting probes. The hyperthermia is one of the most promising means of cancer therapy and it can be a local, regional or systemic treatment. Several retrospective and a few prospective and randomized studies have demonstrated the superiority of using hyperthermic antiblastic perfusion in extremity melanoma as compared to other forms of treatment. The World Health Organization and the European Organization for Research and Treatment of Cancer are performing randomized and controlled studies to evaluate the role of hyperthermic antiblastic perfusion in melanoma