Biochemotherapy for metastatic melanoma with limited central nervous system involvement
| Autor: | Kelly Shinn, Peter D. Boasberg, Pat Ames, Steven J. O'Day, Regina Deck, Maureen Martin, He-Jing Wang, Zbigniew Petrovich, Beth Tamar, Tim S. Kristedja |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Pathology medicine.medical_treatment Central nervous system Interferon alpha-2 Radiosurgery Vinblastine Systemic therapy Metastasis Central nervous system disease Central Nervous System Neoplasms Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Melanoma Aged Neoplasm Staging Chemotherapy business.industry Interferon-alpha General Medicine Middle Aged medicine.disease Survival Analysis Recombinant Proteins Radiation therapy Dacarbazine medicine.anatomical_structure Treatment Outcome Disease Progression Interleukin-2 Female Cisplatin business |
| Zdroj: | Oncology. 64(4) |
| ISSN: | 0030-2414 |
| Popis: | Objectives: Biochemotherapy outcomes were examined in stage IV melanoma patients with previously treated or active central nervous system (CNS) metastases prior to systemic therapy. Patients and Methods: Patients who received biochemotherapy for metastatic melanoma with active or pretreated CNS metastases were compared to patients without evidence of CNS metastases in terms of response, time to progression (TTP), overall survival (OS), and treatment toxicity. Results: Twenty-six (16%) of 159 total patients began biochemotherapy with previously treated or active CNS metastases (group I), compared to 133 (84%) who were radiographically free of CNS involvement (group II). A partial or complete response to biochemotherapy was seen in 13 (50%) group I patients, compared to 56 (42%) group II patients (p = 0.243). The median TTP and median survival were 5.5 and 7.0 months, respectively, for group I patients and 6.0 and 9.9 months, respectively, for group II patients (p = 0.222 and 0.434 for TTP and OS, respectively). Five (19%) group I patients survived longer than 24 months. Gamma Knife radiosurgery or surgical resection of CNS disease prior to biochemotherapy improved survival versus delayed treatment (p = 0.017 and 0.005, respectively). Conclusion: Patients with limited CNS metastases and widespread systemic disease can achieve prolonged survival with targeted treatment of CNS lesions and aggressive systemic therapy. |
| Databáze: | OpenAIRE |
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