Hepatic artery infusion of melphalan in patients with liver metastases from ocular melanoma
Hepatic artery infusion of melphalan in patients with liver metastases from ocular melanoma
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DOI：
10.1002/jso.24984
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发表时间：
2018-04-01
影响因子：
2.5
通讯作者：
Pingpank, James F.
中科院分区：
文献类型：
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作者：
Boone, Brian A.;Perkins, Samantha;Pingpank, James F.
背景和目的：眼黑色素瘤好发于肝转移。全身治疗无效，最佳区域治疗方法定义不清。美法仑隔离肝灌注（IHP）已成为一种可行的治疗选择，但有一部分患者不适合这种治疗。因此，我们试图确定是否可以安全地通过这些patients.MethodsA肝动脉灌注（HAI）的美法仑治疗的患者进行回顾性分析，通过肝动脉管理。所有患者都有IHP禁忌症，并且没有其他治疗选择。美法仑输液重复每四周考虑剂量递增的毒性或显着的疾病progress.ResultsFourteen患者的情况下，从2010年至2015年与美法仑的HAI治疗。所有患者均存在肝功能障碍或肿瘤体积过大，无法进行IHP。无手术相关并发症。30天内死亡3例（21%），中位生存期2.9个月。基线胆红素升高>2.5mg/dL与总生存期较差相关（0.93 vs 6.3个月，P
Background and ObjectivesOcular melanoma has a predilection for liver metastases. Systemic treatment is ineffective and the optimal regional therapy approach is poorly defined. Isolated hepatic perfusion (IHP) with melphalan has emerged as a viable treatment option, however a subset of patients are not candidates for this treatment. We therefore sought to determine if melphalan could be safely administered via the hepatic artery for these patients.MethodsA retrospective review of patients treated with hepatic artery infusion (HAI) of melphalan was undertaken. All patients had contraindications to IHP and were without other therapy options. Melphalan infusion was repeated every four weeks with consideration for dose escalation in the absence of toxicity or significant disease progression.ResultsFourteen patients were treated with HAI of melphalan from 2010 to 2015. All patients had hepatic dysfunction or prohibitive tumor volume precluding IHP. There were no procedure-related complications. Three patients (21%) died within 30 days and the median survival was 2.9 months. Elevated baseline bilirubin >2.5mg/dL was associated with worse overall survival (0.93 vs 6.3 months, P