Artículo
Isolated Limb Perfusion for Malignant Melanoma: Systematic Review on Effectiveness and Safety
Autor/es | Moreno Ramírez, David
Cruz Merino, Luis de la Ferrándiz Pulido, Lara Villegas-Portero, Roman Nieto García, María Adoración |
Departamento | Universidad de Sevilla. Departamento de Medicina |
Fecha de publicación | 2010 |
Fecha de depósito | 2024-01-22 |
Publicado en |
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Resumen | Background. Isolated limb perfusion (ILP) involves the
administration of chemotherapy drugs directly into a
limb involved by locoregional metastases. Unresectable
locally advanced melanoma of the limbs represents one
of ... Background. Isolated limb perfusion (ILP) involves the administration of chemotherapy drugs directly into a limb involved by locoregional metastases. Unresectable locally advanced melanoma of the limbs represents one of the clinical settings in which ILP has demonstrated benefits. Methods. A systematic review of the literature on ILP for patients with unresectable locally advanced melanoma of the limbs was conducted. MEDLINE, EMBASE, and Cochrane database searches were conducted to identify studies fulfilling the following inclusion criteria: hyper- or normothermic ILP with melphalan with or without tumor necrosis factor (TNF) or other drugs providing valid data on clinical response, survival, or toxicity. To allocate levels of evidence and grades of recommendation the Scot-tish Intercollegiate Guidelines Network system was used. Results. Twenty-two studies including 2,018 ILPs were selected with a clear predominance of observational studies (90.90%) against experimental studies (9.10%). The median complete response rate to ILP was of 58.20%, with a median overall response rate of 90.35%. ILP with melphalan yielded a median complete response rate of 46.50%, against a 68.90% median complete response rate for melphalan plus TNF ILP. The median 5-year overall-survival rate was 36.50%, with a median overall survival interval of 36.70 months. The Wieberdink IV and V regional toxicity rates were 2.00% and 0.65%, respectively. Conclusions. ILP is effective in achieving clinical responses in patients with unresectable locally advanced melanoma of the limbs. The disease-free and overall survival rates provided by ILP are acceptable. ILP is safe, with a low incidence of severe regional and systemic toxicity |
Agencias financiadoras | Agencia de Evaluación de Tecnologías Sanitarias de Andalucía |
Identificador del proyecto | AETSA 2007/10 |
Cita | Moreno Ramírez, D., Cruz Merino, L.d.l., Ferrándiz Pulido, L., Villegas-Portero, R. y Nieto García, M.A. (2010). Isolated Limb Perfusion for Malignant Melanoma: Systematic Review on Effectiveness and Safety. Oncologist, 15 (4), 416-427. https://doi.org/10.1634/theoncologist.2009-0325. |
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