A phase II study of the efficacy of diamminedichloroplatinum (cisplatin) for the control of locally recurrent and intransit malignant melanoma of the extremities using tourniquet outflow-occlusion techniques.
Identifieur interne : 001417 ( Pmc/Corpus ); précédent : 001416; suivant : 001418A phase II study of the efficacy of diamminedichloroplatinum (cisplatin) for the control of locally recurrent and intransit malignant melanoma of the extremities using tourniquet outflow-occlusion techniques.
Auteurs : K I Bland ; A K Kimura ; D E Brenner ; M A Basinger ; M. Hirsch ; I F Hawkins ; K K Pierson ; E M CopelandSource :
- Annals of Surgery [ 0003-4932 ] ; 1989.
Abstract
A phase II trial was conducted with 15 patients (mean age of 65.7 years) with locally recurrent or intransit melanoma of the extremities. After total outflow occlusion with pneumatic tourniquet, the cell-cycle nonspecific anti-neoplastic agent cis-diamminedicholoroplatinum (CDDP) was infused intra-arterially in a mean dose of 26.7 mg/m2 per infusion (2.6 infusions per patient). The aim of this study was to determine the efficacy of CDDP infusion for control of intransit and recurrent melanoma of the extremities. Three to four weeks postinfusion, all visible residual disease was resected. Partial remissions were observed in ten patients (67%); five patients achieved stable disease status. No patient had complete regression of disease. At an average follow-up interval of 18.3 months (range 4-44 months), the mean local/regional disease-free survival was 14.8 months. Eighty per cent of patients (twelve of 15) had local/regional control of disease at an average follow-up of 14.8 months after CDDP infusion and surgical resection. Of five melanoma-related deaths, three patients had had no local/regional recurrence at the time of their demise. Three compartment syndromes resulted as a complication of the infusional therapy and occurred within 1-3 days of the treatment. In vitro growth of melanoma from lymph nodes draining the infused area was seen in all subjects studied. Outgrowth from tumor within the tourniquet infusion area was observed in two patients, both of whom experienced recurrences clinically at 24-months' postinfusion. Pharmacokinetic data of total CDDP concentrations from tissue and blood (n = 4) were available from pretreatment to 1 hour post-therapy. Biopsy data from patients pre- and post-treatment suggest substantial tumor uptake of CDDP as compared to local or distal normal skin, with minimal CDDP loss to the systemic circulation. Pharmacologic and clinical data of this phase II trial suggest that intraarterial infusion with tourniquet outflow-occlusion augments tumor tissue levels of CDDP within the infused extremity and enhances local control of high-risk and intransit disease.
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PubMed: 2910216
PubMed Central: 1493892
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A phase II study of the efficacy of diamminedichloroplatinum (cisplatin) for the control of locally recurrent and intransit malignant melanoma of the extremities using tourniquet outflow-occlusion techniques.</title><author><name sortKey="Bland, K I" sort="Bland, K I" uniqKey="Bland K" first="K I" last="Bland">K I Bland</name></author><author><name sortKey="Kimura, A K" sort="Kimura, A K" uniqKey="Kimura A" first="A K" last="Kimura">A K Kimura</name></author><author><name sortKey="Brenner, D E" sort="Brenner, D E" uniqKey="Brenner D" first="D E" last="Brenner">D E Brenner</name></author><author><name sortKey="Basinger, M A" sort="Basinger, M A" uniqKey="Basinger M" first="M A" last="Basinger">M A Basinger</name></author><author><name sortKey="Hirsch, M" sort="Hirsch, M" uniqKey="Hirsch M" first="M" last="Hirsch">M. Hirsch</name></author><author><name sortKey="Hawkins, I F" sort="Hawkins, I F" uniqKey="Hawkins I" first="I F" last="Hawkins">I F Hawkins</name></author><author><name sortKey="Pierson, K K" sort="Pierson, K K" uniqKey="Pierson K" first="K K" last="Pierson">K K Pierson</name></author><author><name sortKey="Copeland, E M" sort="Copeland, E M" uniqKey="Copeland E" first="E M" last="Copeland">E M Copeland</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">2910216</idno><idno type="pmc">1493892</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1493892</idno><idno type="RBID">PMC:1493892</idno><date when="1989">1989</date><idno type="wicri:Area/Pmc/Corpus">001417</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001417</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A phase II study of the efficacy of diamminedichloroplatinum (cisplatin) for the control of locally recurrent and intransit malignant melanoma of the extremities using tourniquet outflow-occlusion techniques.</title><author><name sortKey="Bland, K I" sort="Bland, K I" uniqKey="Bland K" first="K I" last="Bland">K I Bland</name></author><author><name sortKey="Kimura, A K" sort="Kimura, A K" uniqKey="Kimura A" first="A K" last="Kimura">A K Kimura</name></author><author><name sortKey="Brenner, D E" sort="Brenner, D E" uniqKey="Brenner D" first="D E" last="Brenner">D E Brenner</name></author><author><name sortKey="Basinger, M A" sort="Basinger, M A" uniqKey="Basinger M" first="M A" last="Basinger">M A Basinger</name></author><author><name sortKey="Hirsch, M" sort="Hirsch, M" uniqKey="Hirsch M" first="M" last="Hirsch">M. Hirsch</name></author><author><name sortKey="Hawkins, I F" sort="Hawkins, I F" uniqKey="Hawkins I" first="I F" last="Hawkins">I F Hawkins</name></author><author><name sortKey="Pierson, K K" sort="Pierson, K K" uniqKey="Pierson K" first="K K" last="Pierson">K K Pierson</name></author><author><name sortKey="Copeland, E M" sort="Copeland, E M" uniqKey="Copeland E" first="E M" last="Copeland">E M Copeland</name></author></analytic><series><title level="j">Annals of Surgery</title><idno type="ISSN">0003-4932</idno><idno type="eISSN">1528-1140</idno><imprint><date when="1989">1989</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>A phase II trial was conducted with 15 patients (mean age of 65.7 years) with locally recurrent or intransit melanoma of the extremities. After total outflow occlusion with pneumatic tourniquet, the cell-cycle nonspecific anti-neoplastic agent cis-diamminedicholoroplatinum (CDDP) was infused intra-arterially in a mean dose of 26.7 mg/m2 per infusion (2.6 infusions per patient). The aim of this study was to determine the efficacy of CDDP infusion for control of intransit and recurrent melanoma of the extremities. Three to four weeks postinfusion, all visible residual disease was resected. Partial remissions were observed in ten patients (67%); five patients achieved stable disease status. No patient had complete regression of disease. At an average follow-up interval of 18.3 months (range 4-44 months), the mean local/regional disease-free survival was 14.8 months. Eighty per cent of patients (twelve of 15) had local/regional control of disease at an average follow-up of 14.8 months after CDDP infusion and surgical resection. Of five melanoma-related deaths, three patients had had no local/regional recurrence at the time of their demise. Three compartment syndromes resulted as a complication of the infusional therapy and occurred within 1-3 days of the treatment. In vitro growth of melanoma from lymph nodes draining the infused area was seen in all subjects studied. Outgrowth from tumor within the tourniquet infusion area was observed in two patients, both of whom experienced recurrences clinically at 24-months' postinfusion. Pharmacokinetic data of total CDDP concentrations from tissue and blood (n = 4) were available from pretreatment to 1 hour post-therapy. Biopsy data from patients pre- and post-treatment suggest substantial tumor uptake of CDDP as compared to local or distal normal skin, with minimal CDDP loss to the systemic circulation. Pharmacologic and clinical data of this phase II trial suggest that intraarterial infusion with tourniquet outflow-occlusion augments tumor tissue levels of CDDP within the infused extremity and enhances local control of high-risk and intransit disease.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Surg</journal-id><journal-title>Annals of Surgery</journal-title><issn pub-type="ppub">0003-4932</issn><issn pub-type="epub">1528-1140</issn></journal-meta><article-meta><article-id pub-id-type="pmid">2910216</article-id><article-id pub-id-type="pmc">1493892</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>A phase II study of the efficacy of diamminedichloroplatinum (cisplatin) for the control of locally recurrent and intransit malignant melanoma of the extremities using tourniquet outflow-occlusion techniques.</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Bland</surname><given-names>K I</given-names></name></contrib><contrib contrib-type="author"><name><surname>Kimura</surname><given-names>A K</given-names></name></contrib><contrib contrib-type="author"><name><surname>Brenner</surname><given-names>D E</given-names></name></contrib><contrib contrib-type="author"><name><surname>Basinger</surname><given-names>M A</given-names></name></contrib><contrib contrib-type="author"><name><surname>Hirsch</surname><given-names>M</given-names></name></contrib><contrib contrib-type="author"><name><surname>Hawkins</surname><given-names>I F</given-names><suffix>Jr</suffix></name></contrib><contrib contrib-type="author"><name><surname>Pierson</surname><given-names>K K</given-names></name></contrib><contrib contrib-type="author"><name><surname>Copeland</surname><given-names>E M</given-names><suffix>3rd</suffix></name></contrib></contrib-group><aff>Department of Surgery, University of Florida College of Medicine, Gainesville 32610.</aff><pub-date pub-type="ppub"><month>1</month><year>1989</year></pub-date><volume>209</volume><issue>1</issue><fpage>73</fpage><lpage>80</lpage><abstract><p>A phase II trial was conducted with 15 patients (mean age of 65.7 years) with locally recurrent or intransit melanoma of the extremities. After total outflow occlusion with pneumatic tourniquet, the cell-cycle nonspecific anti-neoplastic agent cis-diamminedicholoroplatinum (CDDP) was infused intra-arterially in a mean dose of 26.7 mg/m2 per infusion (2.6 infusions per patient). The aim of this study was to determine the efficacy of CDDP infusion for control of intransit and recurrent melanoma of the extremities. Three to four weeks postinfusion, all visible residual disease was resected. Partial remissions were observed in ten patients (67%); five patients achieved stable disease status. No patient had complete regression of disease. At an average follow-up interval of 18.3 months (range 4-44 months), the mean local/regional disease-free survival was 14.8 months. Eighty per cent of patients (twelve of 15) had local/regional control of disease at an average follow-up of 14.8 months after CDDP infusion and surgical resection. Of five melanoma-related deaths, three patients had had no local/regional recurrence at the time of their demise. Three compartment syndromes resulted as a complication of the infusional therapy and occurred within 1-3 days of the treatment. In vitro growth of melanoma from lymph nodes draining the infused area was seen in all subjects studied. Outgrowth from tumor within the tourniquet infusion area was observed in two patients, both of whom experienced recurrences clinically at 24-months' postinfusion. Pharmacokinetic data of total CDDP concentrations from tissue and blood (n = 4) were available from pretreatment to 1 hour post-therapy. Biopsy data from patients pre- and post-treatment suggest substantial tumor uptake of CDDP as compared to local or distal normal skin, with minimal CDDP loss to the systemic circulation. Pharmacologic and clinical data of this phase II trial suggest that intraarterial infusion with tourniquet outflow-occlusion augments tumor tissue levels of CDDP within the infused extremity and enhances local control of high-risk and intransit disease.</p></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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