dc.creator | Sevilla Ortega, Lourdes | es |
dc.creator | Ferrándiz Pulido, Lara | es |
dc.creator | Palazón Carrión, Natalia | es |
dc.creator | Araji Tiliani, Omar | es |
dc.creator | Barquero Aroca, José M. | es |
dc.creator | Moreno Ramírez, David | es |
dc.creator | Cruz Merino, Luis de la | es |
dc.date.accessioned | 2022-09-08T16:30:48Z | |
dc.date.available | 2022-09-08T16:30:48Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Sevilla Ortega, L., Ferrándiz Pulido, L., Palazón Carrión, N., Araji Tiliani, O., Barquero Aroca, J.M., Moreno Ramírez, D. y Cruz Merino, L.d.l. (2021). Role of Isolated Limb Perfusion in the Era of Targeted Therapies and Immunotherapy in Melanoma. A Systematic Review of The Literature. Cancers, 13 (21), 1-19. | |
dc.identifier.issn | 2072-6694 | es |
dc.identifier.uri | https://hdl.handle.net/11441/136909 | |
dc.description.abstract | Background. Isolated limb perfusion (ILP) is a locoregional procedure indicated by
the unresectable melanoma of the limbs. Its complexity and highly demanding multidisciplinary
approach means that it is a technique only implemented in a few referral centers around the globe.
This report aims to examine its potential role in the era of targeted therapies and immunotherapy by
conducting a systematic review of the literature on ILP. Methods. PubMed, Embase and Cochrane
Library were searched. The eligibility criteria included publications from 2000–2020 providing valid
data o effectiveness, survival or toxicity. Studies in which the perfusion methodology was not clearly
described, letters to the editor, non-systematic reviews and studies that applied outdated clinical
guidelines were excluded. To rule out studies of a low methodological quality and assess the risk
of bias, the following aspects were also required: a detailed description of the applied ILP regimen, the clinical context, follow-up periods, analyzed clinical endpoints, and the number of analyzed
ILPs. The disagreements were resolved by consensus. The results are presented in tables and figures.
Results. Twenty-seven studies including 2637 ILPs were selected. The median overall response
rate was 85%, with a median complete response rate of 58.5%. The median overall survival was
38 months, with a 5-year overall survival of 35%. The toxicity was generally mild according to
Wieberdink toxicity criteria. Discussion. ILP still offer a high efficacy in selected patients. The
main limitation of our review is the heterogeneity and age of most of the articles, as well as the
absence of clinical trials comparing ILP with other procedures, making it difficult to transfer its
results to the current era. Conclusions. ILP is still an effective and safe procedure for selected patients
with unresectable melanoma of the limbs. In the era of targeted therapies and immunotherapy,
ILP remains an acceptable and reasonable palliative treatment alternative, especially to avoid limb
amputations. The ongoing clinical trials combining systemic therapies and ILP will provide more
valuable information in the future to clarify the potential synergism of both strategies. | es |
dc.format | application/pdf | es |
dc.format.extent | 19 p. | es |
dc.language.iso | eng | es |
dc.publisher | MDPI | es |
dc.relation.ispartof | Cancers, 13 (21), 1-19. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Malignant melanoma | es |
dc.subject | Chemotherapy | es |
dc.subject | Isolated limb perfusion | es |
dc.subject | Melphalan | es |
dc.subject | Tumor necrosis factor | es |
dc.title | Role of Isolated Limb Perfusion in the Era of Targeted Therapies and Immunotherapy in Melanoma. A Systematic Review of The Literature | es |
dc.type | info:eu-repo/semantics/article | es |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Cirugía | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Medicina | es |
dc.relation.publisherversion | https://www.mdpi.com/2072-6694/13/21/5485 | es |
dc.identifier.doi | 10.3390/cancers13215485 | es |
dc.journaltitle | Cancers | es |
dc.publication.volumen | 13 | es |
dc.publication.issue | 21 | es |
dc.publication.initialPage | 1 | es |
dc.publication.endPage | 19 | es |