Comparison of Leakage Measurement Using ^99mTc-Labeled Red Blood Cells and Peripheral Melphalan Determination in Hyperthermic Isolation Perfusion of the Extremities

Abstract

The effectiveness of the therapy of malignant melanoma is thought to be improved by in addition hyperthermic isolation perfusion with the alkylating agent melphalan to wide excision [3, 7, 10, 12]. The advantages offered by this technique are the limitation of hyperthermia to the tumor-bearing extremities and the establishment of high concentrations of the cytostatic in the perfusion circuit. Judged on the basis of tissue weight the dosage of melphalan which can be administered during isolation perfusion exceeds manyfold the dosages tolerated during multiple oral dosing [1, 2, 5, 13]. Despite attempts to isolate the extremity completely by surgical techniques, leakage of perfusate containing high amounts of cytostatics into the systemic circulation cannot be prevented completely [6, 8]. In this study an attempt is made to determine whether or not the concentrations of melphalan in the systemic circulation correlate quantitatively with the leakage of ^99mTc-labeled erythrocytes. If such a correlation exists, then Tc leakage could indicate the amount of drug reaching the systemic circulation. This information may influence intraoperative decisions.

This study was supported by the Deutsche Krebshilfe/Dr. Mildred Scheel Stiftung.