caa a22 4500 445334053 CHVBK 20180317142747.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1245/s10434-011-1646-y doi (NATIONALLICENCE)springer-10.1245/s10434-011-1646-y Does Increased Experience with Isolated Limb Infusion for Advanced Limb Melanoma Influence Outcome? A Comparison of Two Treatment Periods at a Single Institution [Elektronische Daten] [Anna Huismans, Hidde Kroon, Peter Kam, John Thompson] Background: Isolated limb infusion (ILI) with cytotoxic drugs has been used since 1992 to treat advanced melanoma confined to a limb. Over this time the technique has undergone progressive modification. In this study we evaluated our experience with ILI by analyzing outcome and toxicity from an "early” and a "late” treatment period. Methods: We compared the results from our institution for 94 patients treated by ILI in the early period (1992-1999) with the results for 91 patients treated in the late period (2000-2007). All patients had advanced limb melanoma and received a combination of melphalan and actinomycin D. Results: The patient characteristics of the early and late groups were similar, but there was greater tumor load in the late group, who had a significantly greater number of lesions (median 4 vs. 5; p=0.02) and deeper tumor infiltration (p=0.03). Drug circulation times were longer in the late group: 22 vs. 31min (p<0.0001). In the late group, higher initial and final limb temperatures were achieved. Overall response rates were 85% in both groups. The late treatment group showed a trend towards less toxicity (p=0.06). Conclusions: Response rates and survival following ILI for advanced melanoma in our late treatment period were similar to those of our early treatment period, despite the significantly greater tumor load of the patients treated in the late period. This could be attributed to increased experience and protocol modifications, which allowed longer drug exposure times and higher limb temperatures to be achieved without increased toxicity. Society of Surgical Oncology, 2011 Huismans Anna Melanoma Institute Australia, Sydney, NSW, Australia aut Kroon Hidde Melanoma Institute Australia, Sydney, NSW, Australia aut Kam Peter Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney, NSW, Australia aut Thompson John Melanoma Institute Australia, Sydney, NSW, Australia aut Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 1877-1883 1068-9265 18:7<1877 2011 18 10434 https://doi.org/10.1245/s10434-011-1646-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1646-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Huismans Anna Melanoma Institute Australia, Sydney, NSW, Australia aut NATIONALLICENCE 700 1- Kroon Hidde Melanoma Institute Australia, Sydney, NSW, Australia aut NATIONALLICENCE 700 1- Kam Peter Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney, NSW, Australia aut NATIONALLICENCE 700 1- Thompson John Melanoma Institute Australia, Sydney, NSW, Australia aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 1877-1883 1068-9265 18:7<1877 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer