Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/80710
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Type: | Journal article |
Title: | Isolated limb infusion chemotherapy for melanoma: an overview of early experience at the Adelaide Melanoma Unit |
Author: | Giles, M. Coventry, B. |
Citation: | Cancer Management and Research, 2013; 5(1):243-249 |
Publisher: | Dove Medical Press Ltd |
Issue Date: | 2013 |
ISSN: | 1179-1322 1179-1322 |
Statement of Responsibility: | Mitchell H Giles, Brendon J Coventry |
Abstract: | Background: Isolated limb infusion (ILI) using cytotoxic agents has been demonstrated to be an effective and less invasive alternative modality than isolated limb perfusion for the treatment of melanoma localized to a limb. Percutaneous catheters were inserted into the axial artery and vein of the affected limb while using a pneumatic cuff to restrict limb vascular flow proximally to "isolate" the limb from the body and enable delivery of high-dose intra-arterial chemotherapy selectively to the limb. The ILI technique was developed at the Sydney Melanoma Unit (now renamed the Melanoma Institute Australia), and only a few other centers have reported separate results. We report our early results using the ILI technique for management of locally recurrent surgically nonresectable melanoma. Methods and results: Twenty-eight ILI procedures were performed in 20 patients treated with one or more procedures between 1997 and 2007. Patient parameters and clinical responses were evaluated. The median follow-up duration was 15.9 months after the first ILI, with an overall response rate after one or more infusions of 70%, of which 35% were complete responders and 35% were partial responders, with a further 20% showing stable disease, giving a "clinically significant" response rate of 90%. After one ILI (n = 20), the overall response rate was 70%, with 20% complete responders and 50% partial responders, and 20% with stable disease. Low limb toxicities were generally observed, and no amputations were required. Conclusion: ILI chemotherapy is a useful technique, which can be readily repeated for control of melanoma in the limb. It is generally well tolerated, and is capable of achieving a cure, delayed progression, or effective palliation in selected cases. The longest survivors in this series were 8 and 10 years from the last ILI. |
Keywords: | metastatic melanoma melphalan actinomycin-D regional therapy intra-arterial infusion |
Rights: | © 2013 Giles and Coventry, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. |
DOI: | 10.2147/CMAR.S45746 |
Published version: | http://dx.doi.org/10.2147/cmar.s45746 |
Appears in Collections: | Aurora harvest Surgery publications |
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hdl_80710.pdf | Published version | 716.29 kB | Adobe PDF | View/Open |
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