BACKGROUND AND OBJECTIVES: Dose reduction and shortening of duration of perfusion in isolated limb perfusion with TNF-α and Melphalan (TM-ILP) are associated with less systemic toxicity and seem to be safe and effective on short-term. However, data on long-term patient outcome are scarce. METHODS: From 1991 to 2008, 102 TM-ILPs were performed in 98 patients for a locally advanced soft tissue sarcoma of the extremity. Perfusions were categorized in three groups: (A) high dose and long duration (n = 59), (B) high dose and short duration (n = 16), and (C) low dose and short duration (n = 27). Long-term local control rates and (limb)-survival were evaluated. RESULTS: Limb salvage rates were in group A 76.3%, B 62.5%, and C 85.2% (P = 0.2). With a median follow up of 76 (range 4-203) months, 50 patients were still alive (51%). Disease-specific 5-year survival was not different between the three groups: A 55.4%, B 52.5%, and C 57.3% (P = 0.9). There was no difference in local recurrence-free 5-year survival (adjusted P = 0.1) and distant metastases-free survival (P = 0.9). CONCLUSIONS: Dose reduction and shorter duration of TM-ILP seem to be safe and effective regarding long-term patient outcome, as 5-year local control rates and (limb)-survival are not compromised.
BACKGROUND AND OBJECTIVES: Dose reduction and shortening of duration of perfusion in isolated limb perfusion with TNF-α and Melphalan (TM-ILP) are associated with less systemic toxicity and seem to be safe and effective on short-term. However, data on long-term patient outcome are scarce. METHODS: From 1991 to 2008, 102 TM-ILPs were performed in 98 patients for a locally advanced soft tissue sarcoma of the extremity. Perfusions were categorized in three groups: (A) high dose and long duration (n = 59), (B) high dose and short duration (n = 16), and (C) low dose and short duration (n = 27). Long-term local control rates and (limb)-survival were evaluated. RESULTS: Limb salvage rates were in group A 76.3%, B 62.5%, and C 85.2% (P = 0.2). With a median follow up of 76 (range 4-203) months, 50 patients were still alive (51%). Disease-specific 5-year survival was not different between the three groups: A 55.4%, B 52.5%, and C 57.3% (P = 0.9). There was no difference in local recurrence-free 5-year survival (adjusted P = 0.1) and distant metastases-free survival (P = 0.9). CONCLUSIONS: Dose reduction and shorter duration of TM-ILP seem to be safe and effective regarding long-term patient outcome, as 5-year local control rates and (limb)-survival are not compromised.
Authors: Jan P Deroose; Alexander M M Eggermont; Albertus N van Geel; Johannes H W de Wilt; Jacobus W A Burger; Cornelis Verhoef Journal: Ann Surg Oncol Date: 2011-08-31 Impact factor: 5.344
Authors: Marc G Stevenson; Lukas B Been; Harald J Hoekstra; Albert J H Suurmeijer; Ronald Boellaard; Adrienne H Brouwers Journal: EJNMMI Res Date: 2018-06-07 Impact factor: 3.138