Document Detail


Isolated limb perfusion for melanoma: effectiveness and toxicity of cisplatin compared with that of melphalan and other drugs.
MedLine Citation:
PMID:  1561803     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In patients with advanced or recurrent melanoma confined to a limb, hyperthermic isolated limb perfusion (ILP) with melphalan produces complete remission in 35-40% of cases and partial remission in a further 35-40%. Mild or moderate limb toxicity is usual, but severe toxic reactions in the limb sometimes occur. After preliminary reports suggested that cisplatin administered by ILP was even more effective than melphalan yet less toxic, a study was undertaken to further assess the value of hyperthermic ILP with cisplatin in the management of limb melanoma. Ten patients were treated. The procedure failed to eliminate melanoma in the limb in 5 of the 6 who received therapeutic ILPs for recurrent disease, and recurrence developed in 2 of the 4 patients who received prophylactic ILPs. Toxicity in the perfused limbs was unacceptably high, with 2 of the 10 patients having severe reactions, one necessitating amputation. We conclude from the results of this study and from a review of literature that neither cisplatin nor any other drug or drug combination so far used for ILP in melanoma patients achieves results which are clearly superior to those achieved with melphalan. Studies are currently in progress investigating double perfusion protocols, new strategies with regional hyperthermia, and the administration by ILP of biological response modifiers such as tumor necrosis factor and interferon. However, for the present, hyperthermic ILP with melphalan remains the treatment most likely to be successful in eliminating or controlling advanced or recurrent melanoma in a limb.
Authors:
J F Thompson; M P Gianoutsos
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  World journal of surgery     Volume:  16     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:    1992 Mar-Apr
Date Detail:
Created Date:  1992-05-13     Completed Date:  1992-05-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  227-33     Citation Subset:  IM    
Affiliation:
Sydney Melanoma Unit, Royal Prince Alfred Hospital, New South Wales, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  therapeutic use*
Chemotherapy, Cancer, Regional Perfusion* / methods
Cisplatin / administration & dosage,  adverse effects,  therapeutic use*
Combined Modality Therapy
Extremities*
Female
Humans
Hyperthermia, Induced
Male
Melanoma / drug therapy*,  surgery
Melphalan / administration & dosage,  adverse effects,  therapeutic use*
Middle Aged
Skin Neoplasms / drug therapy*,  surgery
Time Factors
Chemical
Reg. No./Substance:
148-82-3/Melphalan; 15663-27-1/Cisplatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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