cactinomycin and Sarcoma

Isolated limb infusion (ILI) is a percutaneous method of delivering regional chemotherapy to patients with recurrent tumors of the extremity. This study determines predictors of response, survival, and limb salvage.. Single institution data from a prospective clinical trial and subsequent ILI experience were reviewed. Limb tumor burden was assessed in melanoma patients with "high" (≥10 lesions or one lesion >3 cm) or "low" burden (<10 lesions and no lesion >3 cm). Response was assessed at 3 months from ILI.. Between 1999 and 2011, 62 patients underwent ILI (58 melanoma, 2 Merkel cell carcinoma (MCC), 2 soft tissue sarcoma (STS)). Low tumor burden patients had more complete responses (CR) (11/23, 48%) than high tumor burden (3/32, 9%, P < 0.001); they had higher 5-year survival (69% vs. 29%, P = .007). Five-year survival rates based on response: 91% CR, 53% partial response (PR), 25% less than PR (P = 0.042, CR vs. PR). 7 patients (11%) underwent amputation due to disease progression; 3 had prior CR or PR.. Low tumor burden is a significant predictor of response in melanoma patients. Response to ILI is a significant predictor of survival. Progression of limb disease requiring amputation is not associated with any factors.

Topics: Adult; Aged; Amputation, Surgical; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Merkel Cell; Chemotherapy, Cancer, Regional Perfusion; Dactinomycin; Disease Progression; Drug Administration Schedule; Extremities; Female; Humans; Kaplan-Meier Estimate; Limb Salvage; Male; Melanoma; Melphalan; Middle Aged; Neoplasm Staging; Prospective Studies; Retrospective Studies; Sarcoma; Skin Neoplasms; Treatment Outcome; Tumor Burden

Topics: Anti-Bacterial Agents; Antineoplastic Agents; Dactinomycin; Hodgkin Disease; Humans; Leukemia; Leukemia, Lymphoid; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Mycosis Fungoides; Neoplasms; Sarcoma