Abstract
Background: The treatment of patients with advanced or recurrent pelvic melanoma, which are often associated with lesions in the lower limbs, is still unsatisfactory and controversial. A simplified hypoxic pelvic and limb perfusion has been recently recommended to provide therapeutic options for palliation and possibly cure. Methods: A nonrandomized and noncontrolled phase II experimental study was performed in 11 patients with symptomatic unresectable recurrent melanoma of the pelvis and limb. Patients were submitted to hypoxic pelvic and limb perfusion with 25 mg/m2 of melphalan, 50 mg/m2 of cisplatin, 300 mg/m2 of dacarbazine, and 75 mg/m2 of epirubicin by means of a simplified balloon occlusion technique. Response rate and time to disease progresion were the primary endpoints; overall survival was the secondary endpoint. Results: During the procedures there were no technical, hemodynamic, or vascular complications, and no deaths occurred during surgery or in the postoperative period. Response rate was 82% (95% confidence interval, 58% to 100%). Median time to disease progression was 12 months (range 9 to 30 months). Three-year overall survival was 34%. Conclusions: Hypoxic pelvic and limb perfusion is a safe and good palliative treatment for patients with unresectable recurrent melanoma. Further studies are necessary to to confirm these data and to establish if refinements can be made with acceptable toxicity.
| Original language | English |
|---|---|
| Pages (from-to) | 28-36 |
| Number of pages | 9 |
| Journal | American Journal of Surgery |
| Volume | 183 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2002 |
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Keywords
- Hypoxia
- Locoregional chemotherapy
- Melanoma
- Melphalan
- Perfusion
- Stop flow
ASJC Scopus subject areas
- Surgery
Cite this
Deliberate hypoxic pelvic and limb chemoperfusion in the treatment of recurrent melanoma. / Guadagni, Stefano; Russo, Filippo; Rossi, Carlo Riccardo; Pilati, Pier Luigi; Miotto, Diego; Fiorentini, Giammaria; Deraco, Marcello; Santinami, Mario; Palumbo, Giancarlo; Valenti, Marco; Amicucci, Gianfranco.
In: American Journal of Surgery, Vol. 183, No. 1, 2002, p. 28-36.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Deliberate hypoxic pelvic and limb chemoperfusion in the treatment of recurrent melanoma
AU - Guadagni, Stefano
AU - Russo, Filippo
AU - Rossi, Carlo Riccardo
AU - Pilati, Pier Luigi
AU - Miotto, Diego
AU - Fiorentini, Giammaria
AU - Deraco, Marcello
AU - Santinami, Mario
AU - Palumbo, Giancarlo
AU - Valenti, Marco
AU - Amicucci, Gianfranco
PY - 2002
Y1 - 2002
N2 - Background: The treatment of patients with advanced or recurrent pelvic melanoma, which are often associated with lesions in the lower limbs, is still unsatisfactory and controversial. A simplified hypoxic pelvic and limb perfusion has been recently recommended to provide therapeutic options for palliation and possibly cure. Methods: A nonrandomized and noncontrolled phase II experimental study was performed in 11 patients with symptomatic unresectable recurrent melanoma of the pelvis and limb. Patients were submitted to hypoxic pelvic and limb perfusion with 25 mg/m2 of melphalan, 50 mg/m2 of cisplatin, 300 mg/m2 of dacarbazine, and 75 mg/m2 of epirubicin by means of a simplified balloon occlusion technique. Response rate and time to disease progresion were the primary endpoints; overall survival was the secondary endpoint. Results: During the procedures there were no technical, hemodynamic, or vascular complications, and no deaths occurred during surgery or in the postoperative period. Response rate was 82% (95% confidence interval, 58% to 100%). Median time to disease progression was 12 months (range 9 to 30 months). Three-year overall survival was 34%. Conclusions: Hypoxic pelvic and limb perfusion is a safe and good palliative treatment for patients with unresectable recurrent melanoma. Further studies are necessary to to confirm these data and to establish if refinements can be made with acceptable toxicity.
AB - Background: The treatment of patients with advanced or recurrent pelvic melanoma, which are often associated with lesions in the lower limbs, is still unsatisfactory and controversial. A simplified hypoxic pelvic and limb perfusion has been recently recommended to provide therapeutic options for palliation and possibly cure. Methods: A nonrandomized and noncontrolled phase II experimental study was performed in 11 patients with symptomatic unresectable recurrent melanoma of the pelvis and limb. Patients were submitted to hypoxic pelvic and limb perfusion with 25 mg/m2 of melphalan, 50 mg/m2 of cisplatin, 300 mg/m2 of dacarbazine, and 75 mg/m2 of epirubicin by means of a simplified balloon occlusion technique. Response rate and time to disease progresion were the primary endpoints; overall survival was the secondary endpoint. Results: During the procedures there were no technical, hemodynamic, or vascular complications, and no deaths occurred during surgery or in the postoperative period. Response rate was 82% (95% confidence interval, 58% to 100%). Median time to disease progression was 12 months (range 9 to 30 months). Three-year overall survival was 34%. Conclusions: Hypoxic pelvic and limb perfusion is a safe and good palliative treatment for patients with unresectable recurrent melanoma. Further studies are necessary to to confirm these data and to establish if refinements can be made with acceptable toxicity.
KW - Hypoxia
KW - Locoregional chemotherapy
KW - Melanoma
KW - Melphalan
KW - Perfusion
KW - Stop flow
UR - http://www.scopus.com/inward/record.url?scp=0036178729&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036178729&partnerID=8YFLogxK
U2 - 10.1016/S0002-9610(01)00841-8
DO - 10.1016/S0002-9610(01)00841-8
M3 - Article
C2 - 11869699
AN - SCOPUS:0036178729
VL - 183
SP - 28
EP - 36
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 1
ER -