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The journal «ONCOSURGERY» 2012, Vol.4, No 3

Isolated lung chemoperfusion for metastases of solid tumors

Levchenko ЕV, Senchik КJu, Barchuk АS, Lemekhov VG, Timofeeva ЕS, Dunaevskiy IV, Gelfond VМ, Gorokhov LV, Arseniev АI, Radjabova ZА, Ergnyan SМ, Dolgopolskiy МN, Moiseenko VМ

NN Petrov Cancer Research Institute, the department of thoracic oncology, Saint-Petersburg, Russia
Contact: Levchenko EV, e-mail:

In the period from February 2007 to May 2011, 50 normothermic (37oС) isolated lung chemoperfusions (ILCP) with metastasectomy were performed in 37 patients with isolated lung metastases (soft tissue sarcoma – 9, osteosarcoma – 3, chondrosarcoma – 2, melanoma of skin – 2, uterine sarcoma – 2, renal carcinoma – 4, cancer of salivary glands – 3, rectal – 6, colon – 1, breast – 2, endometrial – 1, cervical cancer – 2). Among them 28 perfusions were with melfalan (30 mg – 1; 45 mg – 3; 50 mg – 24) and 22 – with cisplatin (135 mg/m2), 3 patients had hyperthermic (42oС) ILCP with melfalan in dose of 45 mg. The perfusion time accounted for 30 min. The mean age of patients was 42 years (from 18 to 61).

There were no deaths. The following complications of normothermic ILCP were observed: postperfusional interstitial pulmonary edema in 7 patients (13,2%), lobe pulmonary edema – in 1 patient (1,9%), anaemia – in 10 (18,9% ), nausea – in 4 (7,5%), vomit – in 4 (7,5%), atrial fibrillation – in 2 (3,8%), microfocal pneumonia – in 1 (1,9%) , chylothorax – in 1 (1,9%). All complications were managed medically. In one case urgent surgery was performed for intrapleural bleeding. For hyperthermic ILCP all 3 patients had postperfusional interstitial pulmonary edema in acute postoperative period. One female patient had repeated tracheal intubation for severe respiratory failure and prolonged artificial lung ventilation.

The median follow-up was 17 months. Thirty patients are alive without recurrence. Seven patients had disease progression, 5 of them died.

Conclusion: ILCP with melfalan and cisplatin is replicable, relatively safe and well-tolerated. The hyperthermic ILCP is associated with high risk of postoperative complications. ILCP may be considered as possible component of multimodal treatment in patients with isolated lung metastases, which can improve life-quality and increase lifetime of patients, particularly for failure of other methods of treatment.

KEY WORDS: isolated lung perfusion, metastasectomy, lung metastais, melfalan, cisplatin.

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