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Isolated limb infusion chemotherapy with or without hemofiltration for recurrent limb melanoma

World Journal of Clinical Oncology 2015年第4期6卷 57-63页

作者： Sara Cecchini Donatella Sarti Stefano Ricci Ludovico Delle Vergini manuela sallei Stefano Serresi Giuseppe Ricotti Luca Mulazzani Fabrizia Lattanzio Giammaria Fiorentini Department of Vascular and Interventional Radiology INRCA Hospital- IRCCS Department of Oncology-Hematology "Azienda Ospedaliera Ospedali Riuniti Marche Nord" San Salvatore Hospital Unit of Dermatology INRCA Hospital-IRCCS Department of Radiology General Hospital "Azienda Ospedaliera Ospedali Riuniti Marche Nord" Italian National Research Center on Aging Scientific Direction

AIM: To better define the efficacy and the safety of intra-arterial infusion performed with or without hemofiltration for recurrent limb melanoma. METHODS: Patients with the following characteristics were included in the study: recurrent limb melanoma not indicated for surgical resection, measurable disease in the extremity, > 18 years, performances status(Eastern Cooperative Oncology Group) was 0-1 and life expectancy of at least 6 mo. Twenty nine consecutive patients were enrolled in the study. Patients underwent fluoroscopic placement of angiographic arterial and venous catheters to infuse the drug in the artery [isolated limb infusion(ILI)], and to stop the out flow(venous). Melphalan was rapidly infused into the isolated limb via the arterial catheter after the inflation of venous balloon catheter. Then the circulation of the limb was completely blocked with a pneumatic cuff at the root of the limb. Haemofiltration(HF) was available only in the main center, and was performed with an extracorporeal perfusion system, in order to reduce high systemic toxic peaks of ***: Thirty seven ILI were done in 29 cases(31 ILI-HF and 6 ILI) between 2001 and 2014 at Ancona and Pesaro Hospitals, Italy. Clinical outcomes were monitored 30 d after treatment. Eleven patients(38%) received infusion of melphalan alone, 7(24%) melphalan associated to mitomicin C and 7(24%) melphalan associated to cisplatin, the remaining 4 were treated with cisplatin, melphalan and epirubicin or cisplatin and mitomicin C. The overall response rate was 66%, in particular, 3 patients(10%) were complete responders and 16(56%) were partial responders; whereas 7 patients(24%) had stable disease, and 3(10%) showed progressive disease. Limb toxicity was assessed adopting Wieberdink scale, with evidence of 90% of low grade(I and II) ***: ILI-HF and ILI are effective and safe treatments for recurrent non-resectable limb melanoma. They present evidence of favorable clinical benefit and

关键词： Metastatic melanoma Melphalan Intraarterial infusion Hemofiltration

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