In a nutshell
This study examined the effectiveness and safety of isolated limb perfusion (ILP) in elderly melanoma patients. Researchers suggested that ILP is an effective option to treat melanoma in elderly patients.
Some background
ILP can be used to treat in-transit metastasis (when cancer cells are almost reaching the lymph nodes) in melanoma patients. ILP is a highly concentrated chemotherapy given to a specific part of the body. Because ILP is an effective treatment with manageable toxic effects it may be beneficial in elderly patients (70 years of age or older). However, studies of the use of ILP in elderly people are rare.
Methods & findings
The objective of this study was to investigate the effectiveness and safety of ILP in elderly melanoma patients.
This study included information on 91 melanoma patients treated with ILP. 44 patients were 70 years or younger, and 47 were over the age of 70. The overall response rate was 81%. 47% saw a complete response (no sign of disease). There was no difference in response rate between younger or older patients.
The average melanoma-specific survival (MSS; time from treatment until death due to melanoma) was 38 months. Average MSS was signifcantly longer in younger patients (45 months) compared to older patients (18 months). Melanoma-specific mortality was 3.86 times higher in older patients. Patients who saw a complete response had a 58% reduced risk of mortality due to melanoma. A complete response was also associated with a longer time before disease progression.
2.2% of patients experienced severe blistering of the skin. 82 patients (90%) experienced moderate side effects. The most common moderate side effect was systemic leakage during ILP (when some chemotherapy goes to the blood during ILP procedure). No amputations were necessary because of severe toxicity.
The bottom line
This study suggested that ILP is a safe option to treat elderly patients with melanoma in-transit metastasis.
Published By :
Annals of Surgical Oncology
Date :
Feb 10, 2017
