Safety and Efficacy of Isolated Limb Infusion Chemotherapy for Advanced Locoregional Melanoma in Elderly Patients: An Australian Multicenter Study

Kroon, Hidde M., Coventry, Brendon J., Giles, Mitchell H., Henderson, Michael A., Speakman, David, Wall, Mark, Barbour, Andrew, Serpell, Jonathan, Paddle, Paul, Smithers, Bernard M. and Thompson, John F. (2017) Safety and Efficacy of Isolated Limb Infusion Chemotherapy for Advanced Locoregional Melanoma in Elderly Patients: An Australian Multicenter Study. Annals of Surgical Oncology, 24 11: 3245-3251. doi:10.1245/s10434-017-6046-5


Author Kroon, Hidde M.
Coventry, Brendon J.
Giles, Mitchell H.
Henderson, Michael A.
Speakman, David
Wall, Mark
Barbour, Andrew
Serpell, Jonathan
Paddle, Paul
Smithers, Bernard M.
Thompson, John F.
Title Safety and Efficacy of Isolated Limb Infusion Chemotherapy for Advanced Locoregional Melanoma in Elderly Patients: An Australian Multicenter Study
Journal name Annals of Surgical Oncology   Check publisher's open access policy
ISSN 1534-4681
1068-9265
Publication date 2017-08-10
Year available 2017
Sub-type Article (original research)
DOI 10.1245/s10434-017-6046-5
Open Access Status Not yet assessed
Volume 24
Issue 11
Start page 3245
End page 3251
Total pages 7
Place of publication New York, United States
Publisher Springer New York
Language eng
Subject 2746 Surgery
2730 Oncology
Abstract Background: Isolated limb infusion (ILI) offers a minimally invasive treatment option for locally advanced extremity melanoma. Objective: The aim of the current study was to evaluate the safety and efficacy of ILI in elderly patients in an Australian multicenter setting. Methods: The results of 316 first ILI procedures, performed between 1992 and 2008 in five Australian institutions, were identified and analyzed, with the main focus on elderly patients (≥75 years of age). All institutions used the same protocol: melphalan was circulated in the isolated limb for 20–30 min (±actinomycin D), and toxicity, responses, and survival were recorded. Results: Characteristics of patients aged ≥75 years (n = 148) were similar to those aged <75 years (n = 168), except that older patients had more melanoma deposits (median 4 vs. 5; p = 0.035) and lower limb volumes (5.4 vs. 6.5 L; p = 0.001). Median drug circulation times were lower in the older group (21 vs. 24 min; p = 0.04), and older patients experienced less limb toxicity (grade III/IV in 22 and 37% of patients, respectively; p = 0.003). A complete response (CR) was seen in 27% of patients aged ≥75 years and in 38% of patients aged <75 years (p = 0.06), while overall response rates were 72 and 77%, respectively (p = 0.30). No difference in survival was seen (p = 0.69). Conclusions: The ILI technique proved safe and effective in elderly patients. When present, toxicity was localized, and lower compared with younger patients, possibly due to shorter drug circulation times. CR rates were higher in younger patients, although not significantly, while overall response and survival were equal. Optimization of perioperative factors in elderly patients may allow response rates to be raised further, while maintaining low toxicity.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Public Health Publications
 
Versions
Version Filter Type
Citation counts: Scopus Citation Count Cited 0 times in Scopus Article
Google Scholar Search Google Scholar
Created: Tue, 22 Aug 2017, 00:13:21 EST by System User on behalf of School of Political Science & Internat'l Studies