The application of hyperthermia in regional chemotherapy

Autor: Stefania Vasselli, Mario Lise, Claudio Botti, Franco Di Filippo, Diana Giannarelli, Gabriella Zupi, Renato Cavaliere, Francesco Cavaliere, M. Anza, R. Garinei, Carlo Riccardo Rossi
Rok vydání: 1998
Předmět:
Oncology
Melphalan
Male
Multivariate analysis
Skin Neoplasms
medicine.medical_treatment
extremities
Antineoplastic Combined Chemotherapy Protocols
antineoplastic agents
Melanoma
Middle Aged
Combined Modality Therapy
Recombinant Proteins
Survival Rate
Female
regional perfusion
medicine.drug
Hyperthermia
medicine.medical_specialty
induced hyperthermia
melanoma
prognosis
survival rate
combined modality therapy
tumor necrosis factor
melphalan
neoplasm staging
clinical trials
Interferon-gamma
Internal medicine
medicine
Humans
Survival rate
Antineoplastic Agents
Alkylating
Proportional Hazards Models
Retrospective Studies
Chemotherapy
business.industry
Proportional hazards model
Tumor Necrosis Factor-alpha
Hyperthermia
Induced
medicine.disease
Survival Analysis
Surgery
Chemotherapy
Cancer
Regional Perfusion
Multivariate Analysis
Neoplasm Recurrence
Local
business
Zdroj: Seminars in surgical oncology. 14(3)
ISSN: 8756-0437
Popis: To evaluate the role of hyperthermia combined with chemotherapy in the loco-regional treatment of tumors, a retrospective analysis was done with 228 limb melanoma patients treated with hyperthermic antiblastic perfusion (HAP). A series of treatment- and tumor-related prognostic factors was analyzed to establish their influence on tumor response, loco-regional control, and survival. Concerning tumor response, the logistic model showed that the number of lesions and the minimal tumor temperature (min T) maintained their individual predictive values (P < 0.000001 and P = 0.04, respectively). For loco-regional control, only the number of lesions had a significant predictive value. No direct correlation was found between the treatment-related variables and loco-regional control. However, the 5-year survival rate was significantly higher for patients who achieved a complete response (CR) (51.5%, P = 0.0033) as compared to those who did not (33.3%), providing indirect evidence of the role of the treatment. Multivariate analysis showed that both disease-free and overall survival are strongly influenced by numerous clinical variables and the min T always maintained its significance. When analyzing the subgroup of 119 patients evaluable for tumor response, the Cox model selected the tumor response as the dominant factor for both disease-free and overall survival. These data seem to demonstrate that the optimization of treatment parameters is crucial in determining the CR rate, which, in turn, positively affects the disease outcome. HAP is the treatment of choice for recurrent limb melanoma, and hyperthermia plays an important role in exploiting the efficacy of this technique. Semin. Surg. Oncol. 14:215–223, 1998. © 1998 Wiley-Liss, Inc.
Databáze: OpenAIRE
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