History of regional chemotherapy for cancer of the extremities Journal Article
| Authors: | Ariyan, C. E.; Brady, M. S. |
| Article Title: | History of regional chemotherapy for cancer of the extremities |
| Abstract: | Patients with recurrent cutaneous or soft tissue malignancies of the extremity provide a unique opportunity to evaluate therapy targeted to the isolated limb. The most common clinical presentation of recurrent extremity malignancy occurs in patients with melanoma. The extremity is the site of primary melanoma in half of patients with the disease 1, and of those with a primary melanoma of Breslow depth ≥1.5 mm, 15% will develop a local or in-transit recurrence 2. Palliation of extremity disease is important in these patients, as median survival after diagnosis of in-transit or locally recurrent disease >2 years 3, 4. Radical approaches to eradication of extremity recurrence are rarely used, although in a highly selected group of patients undergoing amputation, 42% 5-year survival was reported 5. As greater recognition of the palliative nature of extremity therapy has evolved, an emphasis on preservation of limb function has supplanted cure as a more realistic therapeutic goal. While occasional cure can be observed, it would be misleading to propose this as the likely outcome of eradication of recurrent extremity melanoma. Isolated limb perfusion (ILP) was developed as an alternative to amputation in patients with recurrent cancer of the extremity. The concept was that vascular isolation of the limb would allow delivery of higher (and potentially more effective) doses of chemotherapy to the disease in the limb than could be achieved with systemic therapy. |
| Keywords: | cancer survival; treatment outcome; clinical trial; review; cisplatin; drug efficacy; drug potentiation; monotherapy; nonhuman; patient selection; treatment duration; unspecified side effect; drug targeting; alpha interferon; adjuvant therapy; cancer radiotherapy; disease free survival; cancer staging; outcome assessment; recurrent cancer; antineoplastic agent; lymph node dissection; cancer palliative therapy; tumor localization; carboplatin; dacarbazine; melanoma; skin neoplasms; kidney disease; history, 21st century; combination chemotherapy; hemoglobin; melphalan; antineoplastic activity; cancer cell culture; thiotepa; sarcoma; history, 20th century; tumor necrosis factor alpha; gamma interferon; dactinomycin; chemotherapy, cancer, regional perfusion; extremities; medical literature; hyperthermic therapy; hyperthermia, induced; postoperative hemorrhage; neurologic disease; beta interferon; dopamine; clinical trials; soft tissue neoplasms; tumor necrosis factor; limb amputation; systemic inflammatory response syndrome; isolated limb perfusion; hemoglobinuria; limb disease; limb perfusion; postoperative edema; soft tissue cancer |
| Journal Title: | International Journal of Hyperthermia |
| Volume: | 24 |
| Issue: | 3 |
| ISSN: | 0265-6736 |
| Publisher: | Taylor & Francis Group |
| Date Published: | 2008-01-01 |
| Start Page: | 185 |
| End Page: | 192 |
| Language: | English |
| DOI: | 10.1080/02656730701785102 |
| PUBMED: | 18392997 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 17 November 2011" - "CODEN: IJHYE" - "Source: Scopus" |
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