Standardizing Regional Therapy: Developing a Consensus on Optimal Utilization of Regional Chemotherapy Treatments in Melanoma

Beasley, Georgia M.; Tyler, Douglas S.

doi:10.1245/s10434-011-1656-9

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…However, despite the fact that the regional chemotherapy for advanced melanoma confined to the extremities is well-accepted, the treatment approach has not been standardized as the recent review by Beasley et al pointed out. [20] In the current study, we reviewed the clinical outcomes from different sequence of repeat regional therapies to evaluate an optimal treatment approach for patients who present with recurrence after the initial regional therapy.…”

Section: Discussionmentioning

confidence: 99%

A Multi-institutional Experience of Repeat Regional Chemotherapy for Recurrent Melanoma of Extremities

et al. 2011

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Background Hyperthermic isolated limb perfusion (HILP) or isolated limb infusion (ILI) are well-accepted regional chemotherapy techniques for in-transit melanoma of extremity. The role and efficacy of repeat regional chemotherapy for recurrence and which salvage procedure is better remains debatable. We aimed to compare toxicities and clinical outcomes by procedure types and the sequence. Methods Data from 44 patients, who underwent repeat HILPs or ILIs from 3 institutions beginning 1997 to 2010, were retrospectively reviewed. Regional toxicity using Wieberdink (WBD) grade, systemic toxicity using serum creatine phosphokinase level (CPK), length of hospital stay (LOS), response rates (RR) at 3 months post-procedure, and time to in-field progression (TTP) were analyzed. Results Of 44 pts, 45.5% were male, 54.5% female with a median age of 66 years (range, 29–85) at diagnosis. The median follow-up was 21.4 months (range, 4 – 153). Of 70 ILIs and 28 HILPs, following groups were identified: A) ILI→ILI (n=25); B) ILI→HILP (n=10); C) HILP→ILI (n=12); D) HILP→HILP (n=3). The comparison of WBD, CPK, LOS and RR between procedures (HILP vs. ILI), between sequence (initial vs. repeat) and their interactions showed no significant differences statistically. TTP after initial procedure did not differ between HILP and ILI (p=0.08), and no survival difference was seen (p=0.65) when TTP after repeat procedure was compared. Conclusions The majority of patients tolerated repeat regional chemotherapy without increased toxicity or LOS; no statistical difference in clinical outcomes were noted when comparing repeat procedures even though repeat HILPs showed higher complete response compared to repeat ILIs.

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Section: Discussionmentioning

confidence: 99%

A Multi-institutional Experience of Repeat Regional Chemotherapy for Recurrent Melanoma of Extremities

et al. 2011

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“…The addition of tumor necrosis factor alpha has been reported to be beneficial in patients with bulky tumor nodules; perfusion with this drug combination is discussed in a separate article in this seminar edition. The use of other agents has been investigated, including cisplatin, vindesine, DTIC, fotemustine, interleukin-2, and lymphokine-activated killer cells, but only actinomycin (in combination with melphalan) has been widely used [4][5][6][7][8][9][10][11][12].…”

Section: Techniquementioning

confidence: 99%

Isolated limb perfusion with melphalan for melanoma

Nieweg

Kroon

2014

Journal of Surgical Oncology

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Isolated limb perfusion with melphalan is a well-established and effective treatment for inoperable melanoma metastases of the extremities, with an overall response rate of 80% and a complete response rate of 54%. The surgical technique is complex and serious morbidity can occur, but with attention to detail major side effects can be kept to a minimum. This article reviews the technique, results and other aspects of this sophisticated form of treatment.

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Isolated Limb Infusion

Kroon

2016

Induction Chemotherapy

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Standardizing Regional Therapy: Developing a Consensus on Optimal Utilization of Regional Chemotherapy Treatments in Melanoma

Cited by 4 publications

References 27 publications

A Multi-institutional Experience of Repeat Regional Chemotherapy for Recurrent Melanoma of Extremities

A Multi-institutional Experience of Repeat Regional Chemotherapy for Recurrent Melanoma of Extremities

Isolated limb perfusion with melphalan for melanoma

Isolated Limb Infusion

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