Adjuvant intra-arterial hepatic fotemustine for high-risk uveal melanoma patients.

Details

Serval ID
serval:BIB_56B1D131D184
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Adjuvant intra-arterial hepatic fotemustine for high-risk uveal melanoma patients.
Journal
Melanoma Research
Author(s)
Voelter V., Schalenbourg A., Pampallona S., Peters S., Halkic N., Denys A., Goitein G., Zografos L., Leyvraz S.
ISSN
0960-8931 (Print)
ISSN-L
0960-8931
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
18
Number
3
Pages
220-224
Language
english
Notes
Publication types: Controlled Clinical Trial ; Journal Article
Publication Status: ppublish
Abstract
Uveal melanoma metastases occur most commonly in the liver. Given the 50% mortality rate in patients at high risk of developing liver metastases, we tested an adjuvant intra-arterial hepatic (i.a.h.) chemotherapy with fotemustine after proton beam irradiation of the primary tumour. We treated 22 high-risk patients with adjuvant i.a.h. fotemustine. Planned treatment duration was 6 months, starting with four weekly doses of 100 mg/m(2), and after a 5-week rest, repeated every 3 weeks. The survival of this patient group was compared with that of a 3 : 1 matched control group randomly selected from our institutional database. Half of the patients experienced > or =grade 3 hepatotoxicity (one patient developing cholangitis 8 years later). Catheter-related complications occurred in 18%. With a median follow-up of 4.6 years for the fotemustine group and 8.5 years for the control group, median overall survival was 9 years [95% confidence interval (CI) 2.2-12.7] and 7.4 years (95% CI 5.4-12.7; P=0.5), respectively, with 5-year survival rates of 75 and 56%. Treatment with adjuvant i.a.h. fotemustine is feasible. However, toxicities are important. Although our data suggest a survival benefit, it was not statistically significant. Confirming such a benefit would require a large, internationally coordinated, prospective randomized trial.
Keywords
Adult, Aged, Aged, 80 and over, Antineoplastic Agents/administration & dosage, Antineoplastic Agents/adverse effects, Chemotherapy, Adjuvant, Female, Follow-Up Studies, Hepatic Artery/drug effects, Humans, Infusions, Intra-Arterial, Liver Neoplasms/drug therapy, Liver Neoplasms/secondary, Male, Melanoma/drug therapy, Melanoma/mortality, Middle Aged, Nitrosourea Compounds/administration & dosage, Nitrosourea Compounds/adverse effects, Organophosphorus Compounds/administration & dosage, Organophosphorus Compounds/adverse effects, Recurrence/prevention & control, Risk, Survival Analysis, Uveal Neoplasms/drug therapy, Uveal Neoplasms/mortality
Pubmed
Web of science
Create date
12/02/2009 10:32
Last modification date
20/08/2019 15:10
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