Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity
Clinics
;
67(3): 237-241, 2012. tab
Article
in English
| LILACS
| ID: lil-623097
ABSTRACT
OBJECTIVE:
Isolated limb perfusion combined with melphalan is an accepted treatment for obtaining locoregional control in advanced melanoma of the extremities and other malignant neoplasias restricted to the limb. This study aims to examine the factors associated with toxicity caused by the regional method. We considered the technical aspects of severe complications associated with the procedure in an attempt to diminish the patient morbidity that occurs during the learning curve.METHODS:
We conducted a retrospective analysis of the records of patients who underwent perfusion at the AC Camargo Hospital in São Paulo, Brazil between January 2000 and January 2009. The Wieberdink scale was applied to classify local toxicity and its relation to clinical and laboratory variables.RESULTS:
Fifty-eight perfusions were performed in 55 patients. Most patients (86.2%) presented a toxicity level between I and III. Grade V toxicity was seen in five cases (8.6%), four of which occurred in the first 2 years. Creatine phosphokinase, an important predictive factor for toxicity, had an average value of 231.8 for toxicity grades I-III and 1286.2 for toxicity grades IV-V (p = 0.001). There was a relationship between the melphalan dose and toxicity, which was 77 mg (25 to 130 mg) for toxicity grades I-II and 93.5 mg (45 to 120 mg) for toxicity grades IV-V (p = 0.0204).CONCLUSION:
It is possible to prevent the toxicity associated with melphalan by adjusting the dose according to the patient's body weight (especially for women and obese patients) and the creatine phosphokinase values in the postoperative period.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Skin Neoplasms
/
Body Weight
/
Chemotherapy, Cancer, Regional Perfusion
/
Antineoplastic Combined Chemotherapy Protocols
/
Antineoplastic Agents, Alkylating
/
Leg
/
Melanoma
/
Melphalan
Type of study:
Etiology study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2012
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Barretos Cancer Hospital-Brazil/BR
/
Hospital do Câncer A.C. Camargo/BR
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