Application of hyperthermia in regional isolated perfusion for melanoma of the limbs

In 11 patients with locally inoperable limb melanoma a 'true' hyperthermic (tissue temperatures between 41°C and 42°C) isolated perfusion with melphalan was carried out. After heating the limb to 41°C the cytostatic was administered in doses of 10 mg/l and 13 mg/l perfused tissue for leg and arm perfusions respectively. In spite of good results, seven complete remissions [duration 6+ (1-15+) months] and three partial remissions (durations 4, 7 and 11 months), this approach had to be discontinued because of severe toxicity, requiring amputation in one case. A schedule of sequential administration of hyperthermia and melphalan is at present being studied.