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首页> 外文期刊>Annals of surgical oncology >Isolated limb infusion for in-transit malignant melanoma of the extremity: a well-tolerated but less effective alternative to hyperthermic isolated limb perfusion.
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Isolated limb infusion for in-transit malignant melanoma of the extremity: a well-tolerated but less effective alternative to hyperthermic isolated limb perfusion.

机译：肢体运输性恶性黑色素瘤的孤立肢体输注：一种耐受性强，但效果不佳的替代高温肢体灌注的有效替代方法。

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BACKGROUND: Isolated limb infusion (ILI) is a recently described minimally invasive technique developed in Australia for delivering regional chemotherapy. This study examined the efficacy and toxicity of ILI, compared to hyperthermic isolated limb perfusion (HILP), in treating extremity in-transit melanoma. METHODS: Variables from a prospective single institution database of 120 regionally treated melanoma patients (1995-2007) were compared using chi-square analysis. This included 61 consecutive ILI treatments in 58 patients and 59 HILP treatments in 54 patients. Response was defined at 3 months using the response evaluation criteria in solid tumors (RECIST). ILI was performed using melphalan (LPAM) and dactinomycin for 30 min after limb temperature reached 37 degrees C. HILP was performed using LPAM for 60 min after limb temperature reached 38.5 degrees C. RESULTS: For ILI (n = 61), the complete response (CR) rate was 30%, the partial response (PR) rate was 14%, and there was no response (NR) in 56% of patients. The median duration of CR was 12 months and 18% of patients experienced (grade >or=3) toxicity. HILP (n = 59) was associated with a better (P < 0.001) response rate (CR 57%, PR 31%, and NR 12%) however, more patients (32%) experienced grade >or=3 toxicity (P = 0.037). The dose of LPAM was corrected for ideal body weight (IBW) in 40 out of 61 ILI procedures, and 13 of 59 HILP procedures. This dosing modification was associated with decreased toxicity (P = 0.024) without diminishing response. CONCLUSION: ILI was found to be a well-tolerated alternative to HILP. While ILI does not appear to be as effective as HILP, it does seem to be associated with less morbidity.
机译：背景：孤立肢体输注（ILI）是最近在澳大利亚开发的用于进行局部化疗的微创技术。这项研究检查了ILI与高温隔离肢体灌注（HILP）相比在治疗四肢过境黑色素瘤中的功效和毒性。方法：使用卡方分析比较了来自前瞻性单一机构数据库中120例接受区域治疗的黑色素瘤患者（1995年至2007年）的变量。其中包括58例患者的61例连续ILI治疗和54例患者的59例HILP治疗。使用实体瘤反应评估标准（RECIST）在3个月时定义反应。在肢体温度达到37摄氏度后，使用美法仑（LPAM）和放线菌素进行ILI 30分钟。在肢体温度达到38.5摄氏度后，使用LPAM进行60分钟HILP。结果：对于ILI（n = 61），完全缓解（CR）率为30％，部分缓解（PR）率为14％，56％的患者无缓解（NR）。 CR的中位持续时间为12个月，有18％的患者经历过（≥3级）毒性反应。 HILP（n = 59）与较好的缓解率（P <0.001）（CR 57％，PR 31％和NR 12％）相关，但是，更多的患者（32％）的毒性≥3级（P = 0.037）。在61个ILI程序中的40个和59个HILP程序中的13个中，针对理想体重（IBW）校正了LPAM剂量。这种剂量修改与毒性降低（P = 0.024）相关，而不会降低反应。结论：发现ILI是HILP的良好耐受性替代品。尽管ILI似乎不如HILP有效，但它似乎与发病率较低有关。

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