Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity
Autor(a) principal: | |
---|---|
Data de Publicação: | 2012 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/19660 |
Resumo: | OBJECTIVE: Isolated limb perfusion combined with melphalan is an accepted treatment for obtaining locoregional control in advanced melanoma of the extremities and other malignant neoplasias restricted to the limb. This study aims to examine the factors associated with toxicity caused by the regional method. We considered the technical aspects of severe complications associated with the procedure in an attempt to diminish the patient morbidity that occurs during the learning curve. METHODS: We conducted a retrospective analysis of the records of patients who underwent perfusion at the AC Camargo Hospital in São Paulo, Brazil between January 2000 and January 2009. The Wieberdink scale was applied to classify local toxicity and its relation to clinical and laboratory variables. RESULTS: Fifty-eight perfusions were performed in 55 patients. Most patients (86.2%) presented a toxicity level between I and III. Grade V toxicity was seen in five cases (8.6%), four of which occurred in the first 2 years. Creatine phosphokinase, an important predictive factor for toxicity, had an average value of 231.8 for toxicity grades I-III and 1286.2 for toxicity grades IV-V (p = 0.001). There was a relationship between the melphalan dose and toxicity, which was 77 mg (25 to 130 mg) for toxicity grades I-II and 93.5 mg (45 to 120 mg) for toxicity grades IV-V (p = 0.0204). CONCLUSION: It is possible to prevent the toxicity associated with melphalan by adjusting the dose according to the patient's body weight (especially for women and obese patients) and the creatine phosphokinase values in the postoperative period. |
id |
USP-19_a87e1ed99c6b2612b3ea395d869ab684 |
---|---|
oai_identifier_str |
oai:revistas.usp.br:article/19660 |
network_acronym_str |
USP-19 |
network_name_str |
Clinics |
repository_id_str |
|
spelling |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicityIsolation Perfusion Cancer ChemotherapyHypoxiamelanomaRegional chemotherapyMelphalanOBJECTIVE: Isolated limb perfusion combined with melphalan is an accepted treatment for obtaining locoregional control in advanced melanoma of the extremities and other malignant neoplasias restricted to the limb. This study aims to examine the factors associated with toxicity caused by the regional method. We considered the technical aspects of severe complications associated with the procedure in an attempt to diminish the patient morbidity that occurs during the learning curve. METHODS: We conducted a retrospective analysis of the records of patients who underwent perfusion at the AC Camargo Hospital in São Paulo, Brazil between January 2000 and January 2009. The Wieberdink scale was applied to classify local toxicity and its relation to clinical and laboratory variables. RESULTS: Fifty-eight perfusions were performed in 55 patients. Most patients (86.2%) presented a toxicity level between I and III. Grade V toxicity was seen in five cases (8.6%), four of which occurred in the first 2 years. Creatine phosphokinase, an important predictive factor for toxicity, had an average value of 231.8 for toxicity grades I-III and 1286.2 for toxicity grades IV-V (p = 0.001). There was a relationship between the melphalan dose and toxicity, which was 77 mg (25 to 130 mg) for toxicity grades I-II and 93.5 mg (45 to 120 mg) for toxicity grades IV-V (p = 0.0204). CONCLUSION: It is possible to prevent the toxicity associated with melphalan by adjusting the dose according to the patient's body weight (especially for women and obese patients) and the creatine phosphokinase values in the postoperative period.Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2012-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/19660DOI:10.6061/clinics/2012(03)06Clinics; Vol. 67 No. 3 (2012); 237-241Clinics; v. 67 n. 3 (2012); 237-241Clinics; Vol. 67 Núm. 3 (2012); 237-2411980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/19660/21724Duprat Neto, João PedreiraOliveira, FernandaBertolli, EduardoMolina, Andre SapataNishinari, KenjiFacure, LucianaFregnani, Jose Humbertoinfo:eu-repo/semantics/openAccess2012-05-24T18:49:06Zoai:revistas.usp.br:article/19660Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2012-05-24T18:49:06Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity |
title |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity |
spellingShingle |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity Duprat Neto, João Pedreira Isolation Perfusion Cancer Chemotherapy Hypoxia melanoma Regional chemotherapy Melphalan |
title_short |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity |
title_full |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity |
title_fullStr |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity |
title_full_unstemmed |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity |
title_sort |
Isolated limb perfusion with hyperthermia and chemotherapy: predictive factors for regional toxicity |
author |
Duprat Neto, João Pedreira |
author_facet |
Duprat Neto, João Pedreira Oliveira, Fernanda Bertolli, Eduardo Molina, Andre Sapata Nishinari, Kenji Facure, Luciana Fregnani, Jose Humberto |
author_role |
author |
author2 |
Oliveira, Fernanda Bertolli, Eduardo Molina, Andre Sapata Nishinari, Kenji Facure, Luciana Fregnani, Jose Humberto |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Duprat Neto, João Pedreira Oliveira, Fernanda Bertolli, Eduardo Molina, Andre Sapata Nishinari, Kenji Facure, Luciana Fregnani, Jose Humberto |
dc.subject.por.fl_str_mv |
Isolation Perfusion Cancer Chemotherapy Hypoxia melanoma Regional chemotherapy Melphalan |
topic |
Isolation Perfusion Cancer Chemotherapy Hypoxia melanoma Regional chemotherapy Melphalan |
description |
OBJECTIVE: Isolated limb perfusion combined with melphalan is an accepted treatment for obtaining locoregional control in advanced melanoma of the extremities and other malignant neoplasias restricted to the limb. This study aims to examine the factors associated with toxicity caused by the regional method. We considered the technical aspects of severe complications associated with the procedure in an attempt to diminish the patient morbidity that occurs during the learning curve. METHODS: We conducted a retrospective analysis of the records of patients who underwent perfusion at the AC Camargo Hospital in São Paulo, Brazil between January 2000 and January 2009. The Wieberdink scale was applied to classify local toxicity and its relation to clinical and laboratory variables. RESULTS: Fifty-eight perfusions were performed in 55 patients. Most patients (86.2%) presented a toxicity level between I and III. Grade V toxicity was seen in five cases (8.6%), four of which occurred in the first 2 years. Creatine phosphokinase, an important predictive factor for toxicity, had an average value of 231.8 for toxicity grades I-III and 1286.2 for toxicity grades IV-V (p = 0.001). There was a relationship between the melphalan dose and toxicity, which was 77 mg (25 to 130 mg) for toxicity grades I-II and 93.5 mg (45 to 120 mg) for toxicity grades IV-V (p = 0.0204). CONCLUSION: It is possible to prevent the toxicity associated with melphalan by adjusting the dose according to the patient's body weight (especially for women and obese patients) and the creatine phosphokinase values in the postoperative period. |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/19660 DOI:10.6061/clinics/2012(03)06 |
url |
https://www.revistas.usp.br/clinics/article/view/19660 |
identifier_str_mv |
DOI:10.6061/clinics/2012(03)06 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/19660/21724 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 67 No. 3 (2012); 237-241 Clinics; v. 67 n. 3 (2012); 237-241 Clinics; Vol. 67 Núm. 3 (2012); 237-241 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222758211158016 |