Isolated limb infusion with melphalan and actinomycin D for melanoma: A systematic review
Article first published online: 12 FEB 2014
© 2014 Wiley Periodicals, Inc.
Journal of Surgical Oncology
Special Issue: Seminars in Surgical Oncology: Local and Regional Therapies for Melanoma
Volume 109, Issue 4, pages 348–351, March 15, 2014
How to Cite
Kroon, H. M., Huismans, A. M., Kam, P. C.A. and Thompson, J. F. (2014), Isolated limb infusion with melphalan and actinomycin D for melanoma: A systematic review. J. Surg. Oncol., 109: 348–351. doi: 10.1002/jso.23553
- Issue published online: 12 FEB 2014
- Article first published online: 12 FEB 2014
- Manuscript Received: 12 DEC 2013
- Manuscript Accepted: 12 DEC 2013
- isolated limb perfusion;
- actinomycin D
Isolated limb infusion (ILI) was developed as a simplified and minimally invasive alternative to isolated limb perfusion (ILP) to treat unresectable limb melanoma. A number of centers around the world have reported their results using this procedure. In this study a systematic review of reported ILI experiences was undertaken. A literature search was conducted according to the guidelines for systematic reviews in order to select eligible papers reporting limb toxicity and response rates following ILI using melphalan and actinomycin D to treat limb melanoma. A total of 576 patients from seven publications were included. Regional toxicity following ILI was low: no visible effect of the treatment or slight erythema or edema was observed in 79% of the patients, while considerable erythema and/or edema with blistering was experienced by 19%. In 2% there was a threatened or actual compartment syndrome. No procedure-related amputation was reported. Complete response occurred in 33% of the patients and partial response in 40%, an overall response rate of 73%. Stable disease and progressive disease were achieved in 14% and 13% of the patients, respectively. This first systematic review of ILI procedures using melphalan and actinomycin D indicates that regional toxicity was generally low, with satisfactory response rates. When comparing ILI and ILP, it must be borne in mind that ILI is often performed in significantly older patients and in patients with higher stages of disease, which decreases the likelihood of a favorable response. J. Surg. Oncol. 2014 109:348–351. © 2014 Wiley Periodicals, Inc.