Toxicity and morbidity of isolated limb perfusion.
Identifieur interne : 00BB61 ( Ncbi/Merge ); précédent : 00BB60; suivant : 00BB62Toxicity and morbidity of isolated limb perfusion.
Auteurs : B C Vrouenraets [Pays-Bas] ; J M Klaase ; O E Nieweg ; B B KroonSource :
- Seminars in surgical oncology [ 8756-0437 ]
Descripteurs français
- KwdFr :
- Antinéoplasiques alcoylants (administration et posologie), Antinéoplasiques alcoylants (effets indésirables), Facteur de nécrose tumorale alpha (administration et posologie), Facteur de nécrose tumorale alpha (effets indésirables), Facteurs de risque, Humains, Hyperthermie provoquée, Melphalan (administration et posologie), Melphalan (effets indésirables), Membres, Morbidité, Mélanome (traitement médicamenteux), Perfusion régionale de chimiothérapie anticancéreuse (effets indésirables), Protocoles de polychimiothérapie antinéoplasique (effets indésirables), Protocoles de polychimiothérapie antinéoplasique (usage thérapeutique), Tumeurs cutanées (traitement médicamenteux).
- MESH :
- administration et posologie : Antinéoplasiques alcoylants, Facteur de nécrose tumorale alpha, Melphalan.
- effets indésirables : Antinéoplasiques alcoylants, Facteur de nécrose tumorale alpha, Melphalan, Perfusion régionale de chimiothérapie anticancéreuse, Protocoles de polychimiothérapie antinéoplasique.
- traitement médicamenteux : Mélanome, Tumeurs cutanées.
- usage thérapeutique : Protocoles de polychimiothérapie antinéoplasique.
- Facteurs de risque, Humains, Hyperthermie provoquée, Membres, Morbidité.
English descriptors
- KwdEn :
- Antineoplastic Agents, Alkylating (administration & dosage), Antineoplastic Agents, Alkylating (adverse effects), Antineoplastic Combined Chemotherapy Protocols (adverse effects), Antineoplastic Combined Chemotherapy Protocols (therapeutic use), Chemotherapy, Cancer, Regional Perfusion (adverse effects), Extremities, Humans, Hyperthermia, Induced, Melanoma (drug therapy), Melphalan (administration & dosage), Melphalan (adverse effects), Morbidity, Risk Factors, Skin Neoplasms (drug therapy), Tumor Necrosis Factor-alpha (administration & dosage), Tumor Necrosis Factor-alpha (adverse effects).
- MESH :
- chemical , administration & dosage : Antineoplastic Agents, Alkylating, Melphalan, Tumor Necrosis Factor-alpha.
- chemical , adverse effects : Antineoplastic Agents, Alkylating, Melphalan, Tumor Necrosis Factor-alpha.
- adverse effects : Antineoplastic Combined Chemotherapy Protocols, Chemotherapy, Cancer, Regional Perfusion.
- drug therapy : Melanoma, Skin Neoplasms.
- therapeutic use : Antineoplastic Combined Chemotherapy Protocols.
- Extremities, Humans, Hyperthermia, Induced, Morbidity, Risk Factors.
Abstract
Because a relationship between toxicity and treatment outcome has never been demonstrated for isolated limb perfusion (ILP) with melphalan, it is important to keep the side-effects of the procedure restricted to a minimum. Risk factors for more severe acute regional toxicity have recently been identified with tissue temperature above 40 degrees C and a high melphalan peak concentration being the most important. Acute regional toxicity should be mild taking into account these factors and maintaining the normal physiological conditions in the limb during ILP. This should also decrease the incidence of long-term morbidity, especially ankle stiffness and muscle atrophy, since a relation between the severity of the acute regional tissue reactions and long-term morbidity has been demonstrated. Lymphedema is strongly linked to a concomitant regional lymph node dissection and this operation may be delayed until the acute regional tissue reactions have faded. It is not yet clear whether the addition of tumor necrosis factor-alpha (TNF-alpha) to melphalan increases regional toxicity. In the absence of melphalan leakage to the systemic circulation, systemic toxicity is minimal; this is also true with TNF-alpha. Compared to ILP with melphalan +/- TNF-alpha, ILP with other drugs is less effective and often is associated with increased regional toxicity.
PubMed: 9548605
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pubmed:9548605Le document en format XML
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<country>Pays-Bas</country>
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<term>Antineoplastic Combined Chemotherapy Protocols (adverse effects)</term>
<term>Antineoplastic Combined Chemotherapy Protocols (therapeutic use)</term>
<term>Chemotherapy, Cancer, Regional Perfusion (adverse effects)</term>
<term>Extremities</term>
<term>Humans</term>
<term>Hyperthermia, Induced</term>
<term>Melanoma (drug therapy)</term>
<term>Melphalan (administration & dosage)</term>
<term>Melphalan (adverse effects)</term>
<term>Morbidity</term>
<term>Risk Factors</term>
<term>Skin Neoplasms (drug therapy)</term>
<term>Tumor Necrosis Factor-alpha (administration & dosage)</term>
<term>Tumor Necrosis Factor-alpha (adverse effects)</term>
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<term>Antinéoplasiques alcoylants (effets indésirables)</term>
<term>Facteur de nécrose tumorale alpha (administration et posologie)</term>
<term>Facteur de nécrose tumorale alpha (effets indésirables)</term>
<term>Facteurs de risque</term>
<term>Humains</term>
<term>Hyperthermie provoquée</term>
<term>Melphalan (administration et posologie)</term>
<term>Melphalan (effets indésirables)</term>
<term>Membres</term>
<term>Morbidité</term>
<term>Mélanome (traitement médicamenteux)</term>
<term>Perfusion régionale de chimiothérapie anticancéreuse (effets indésirables)</term>
<term>Protocoles de polychimiothérapie antinéoplasique (effets indésirables)</term>
<term>Protocoles de polychimiothérapie antinéoplasique (usage thérapeutique)</term>
<term>Tumeurs cutanées (traitement médicamenteux)</term>
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<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antineoplastic Agents, Alkylating</term>
<term>Melphalan</term>
<term>Tumor Necrosis Factor-alpha</term>
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<term>Melphalan</term>
<term>Tumor Necrosis Factor-alpha</term>
</keywords>
<keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Antinéoplasiques alcoylants</term>
<term>Facteur de nécrose tumorale alpha</term>
<term>Melphalan</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Antineoplastic Combined Chemotherapy Protocols</term>
<term>Chemotherapy, Cancer, Regional Perfusion</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Melanoma</term>
<term>Skin Neoplasms</term>
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<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Antinéoplasiques alcoylants</term>
<term>Facteur de nécrose tumorale alpha</term>
<term>Melphalan</term>
<term>Perfusion régionale de chimiothérapie anticancéreuse</term>
<term>Protocoles de polychimiothérapie antinéoplasique</term>
</keywords>
<keywords scheme="MESH" qualifier="therapeutic use" xml:lang="en"><term>Antineoplastic Combined Chemotherapy Protocols</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Mélanome</term>
<term>Tumeurs cutanées</term>
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<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Protocoles de polychimiothérapie antinéoplasique</term>
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<term>Humans</term>
<term>Hyperthermia, Induced</term>
<term>Morbidity</term>
<term>Risk Factors</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Facteurs de risque</term>
<term>Humains</term>
<term>Hyperthermie provoquée</term>
<term>Membres</term>
<term>Morbidité</term>
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<front><div type="abstract" xml:lang="en">Because a relationship between toxicity and treatment outcome has never been demonstrated for isolated limb perfusion (ILP) with melphalan, it is important to keep the side-effects of the procedure restricted to a minimum. Risk factors for more severe acute regional toxicity have recently been identified with tissue temperature above 40 degrees C and a high melphalan peak concentration being the most important. Acute regional toxicity should be mild taking into account these factors and maintaining the normal physiological conditions in the limb during ILP. This should also decrease the incidence of long-term morbidity, especially ankle stiffness and muscle atrophy, since a relation between the severity of the acute regional tissue reactions and long-term morbidity has been demonstrated. Lymphedema is strongly linked to a concomitant regional lymph node dissection and this operation may be delayed until the acute regional tissue reactions have faded. It is not yet clear whether the addition of tumor necrosis factor-alpha (TNF-alpha) to melphalan increases regional toxicity. In the absence of melphalan leakage to the systemic circulation, systemic toxicity is minimal; this is also true with TNF-alpha. Compared to ILP with melphalan +/- TNF-alpha, ILP with other drugs is less effective and often is associated with increased regional toxicity.</div>
</front>
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<Title>Seminars in surgical oncology</Title>
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<ArticleTitle>Toxicity and morbidity of isolated limb perfusion.</ArticleTitle>
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<Abstract><AbstractText>Because a relationship between toxicity and treatment outcome has never been demonstrated for isolated limb perfusion (ILP) with melphalan, it is important to keep the side-effects of the procedure restricted to a minimum. Risk factors for more severe acute regional toxicity have recently been identified with tissue temperature above 40 degrees C and a high melphalan peak concentration being the most important. Acute regional toxicity should be mild taking into account these factors and maintaining the normal physiological conditions in the limb during ILP. This should also decrease the incidence of long-term morbidity, especially ankle stiffness and muscle atrophy, since a relation between the severity of the acute regional tissue reactions and long-term morbidity has been demonstrated. Lymphedema is strongly linked to a concomitant regional lymph node dissection and this operation may be delayed until the acute regional tissue reactions have faded. It is not yet clear whether the addition of tumor necrosis factor-alpha (TNF-alpha) to melphalan increases regional toxicity. In the absence of melphalan leakage to the systemic circulation, systemic toxicity is minimal; this is also true with TNF-alpha. Compared to ILP with melphalan +/- TNF-alpha, ILP with other drugs is less effective and often is associated with increased regional toxicity.</AbstractText>
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