Article révisé par les pairs
Résumé : As angiosarcomas are usually present as multicentric lesions, with high vascularization, surgical treatment is difficult without mutilation. Isolation perfusion has been tried as a new treatment. Between 1986 and 1988, five isolation perfusion trials with chemotherapy and mild hyperthermia were performed in our Institute for four cases of angiosarcoma. There were three cases of upper limb angiosarcoma, two after mastectomy and radiotherapy and one on congenital lymphangioma. The last case was a malignant haemangioendothelioma of the lower limb. Two of the patients received melphalan alone (20 μg/ml for the upper limb and 40 μg/ml for the lower limb). The two others received a combination of actinomycin D (0.65 mg/m2) and melphalan. All patients experienced complete response in the perfused limb after 6 weeks. Three patients developed a grade III regional toxicity and the last one a grade IV. One patient died 2.5 months after treatment from pulmonary emboly. The three others have had a disease-free interval of 19, 13, 13 months respectively. The last patient, with angiosarcoma on lymphangioma, was reperfused and had a complete remission for 10 months, than an amputation was performed for a new recurrence. A second patient died of dissiminated disease after 13 months. The two remaining patients are still alive 19 and 33 months after isolation perfusion. It is concluded that isolation perfusion represents an effective limb salvage treatment for angiosarcomas of the limbs.