| The Problem: Surgical treatment of primary tumors, recurrences or metasta-ses may be technically impossible or insufficient to achieve local tumor control. Combination of surgery with infusion or perfusions techniques of organs or extremities, or a combination with peroperative insertion of catheters for peroperative radiotherapy or afterloading can improve the surgical re-sults. The possi-bility to translate the success of isolated limb perfusi-ons with TNFa + cyt-ostatic drugs in patients with irresectable extremity tumors into its application in new regional perfusion settings (pelvis, liver) is under investigation. Moreover a genetherapy program using various vectors has been developed investigating the efficacy of isolated perfusion and regional infusion techniques for these new treatment modalities.The development of treating metastatic disease with tumortargeting devices such as liposomal encapsu-lation of TNF + cytostatic or other antiangiogenic drugs is another arm in the overall program. Opti-malisa-tion of pre- and per-ope-rative diagnostic procedures as well as induction chemo- / radiation therapy may improve the resec-tability of tumors and improve the quality of life. These aspects are investigated in precli-nical animal models and in clini-cal trial protocols. Regional isola-ted perfusion or infusion of cytokines, in particular TNFa or other "antistromal agents" in combination with cytosta-tic drugs are the central research item in this approach of biochemotherapy targeting both structural elements of neoplasms. |
