Treatment of ocular melanoma metastatic to the liver by hepatic arterial chemotherapy.

Détails

ID Serval
serval:BIB_819A47F25CA8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Treatment of ocular melanoma metastatic to the liver by hepatic arterial chemotherapy.
Périodique
Journal of Clinical Oncology
Auteur(s)
Leyvraz S., Spataro V., Bauer J., Pampallona S., Salmon R., Dorval T., Meuli R., Gillet M., Lejeune F., Zografos L.
ISSN
0732-183X
Statut éditorial
Publié
Date de publication
1997
Peer-reviewed
Oui
Volume
15
Numéro
7
Pages
2589-2595
Langue
anglais
Résumé
PURPOSE: Ocular melanoma is characterized by a high rate of liver metastases and is associated with a median survival time less than 5 months. There is no standard treatment available. Treatment strategies have, without success, relied on the experience with metastatic cutaneous melanoma. The only effective treatment is chemoembolization using cisplatin and polyvinyl sponge, which has never become accepted on a large scale. The objective of the study was to establish prospectively the efficacy and toxicity of hepatic intraarterial fotemustine, a third-generation nitrosourea, in patients with liver metastases from ocular melanoma. PATIENTS AND METHODS: Thirty-one patients were subjected to laparotomy to place a totally implantable catheter into the hepatic artery and received fotemustine 100 mg/m2 as a 4-hour infusion, first once a week for four times and then, after a 5-week rest period, every 3 weeks until progression or toxicity. Cox regression models were used to assess the prognostic role of patient survival characteristics. RESULTS: Objective responses were observed in 12 of 30 assessable patients (40%; 95% confidence interval, 22% to 59%). The median duration of response was 11 months and the median overall survival time, 14 months. Lactate dehydrogenase (LDH) appeared to be the strongest prognostic factor for survival. Toxicity was minimal and treatment could be administered on an outpatient basis. CONCLUSION: The results of hepatic arterial chemotherapy with fotemustine produced a high response rate and survival similar to chemoembolization therapy. It involves no major toxicity and preserves the quality of life. To assess further its effectiveness, a randomized study to compare hepatic intraarterial versus intravenous chemotherapy is being planned.
Mots-clé
Adult, Aged, Antineoplastic Agents/administration & dosage, Antineoplastic Agents/adverse effects, Catheters, Indwelling, Eye Neoplasms/pathology, Female, Hepatic Artery, Humans, Infusions, Intra-Arterial, Liver Neoplasms/drug therapy, Liver Neoplasms/pathology, Male, Melanoma/drug therapy, Melanoma/secondary, Middle Aged, Nitrosourea Compounds/administration & dosage, Nitrosourea Compounds/adverse effects, Organophosphorus Compounds/administration & dosage, Organophosphorus Compounds/adverse effects, Prospective Studies, Survival Analysis, Treatment Outcome
Pubmed
Web of science
Création de la notice
08/04/2008 15:47
Dernière modification de la notice
03/03/2018 18:48
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