From 1978 to 1990, 32 patients with Clark V melanoma were treated by wide excision of the primary and adjuvant regional isolated perfusion with melphalan. M.D. Anderson stage of disease was stage I in 22 and stage IIIb in 10 patients. Five-year survival rates were 58% and 27%, respectively. Seven pa
Pharmacokinetics of dacarbazine in the regional perfusion of extremities with melanoma
β Scribed by Didolkar, Mukund S.; Jackson, Andre J.; Lesko, Lawrence J.; Fitzpatrick, J. Lawrence; Buda, Barbara S.; Johnston, Gerald S.; Zech, Loren A.
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 811 KB
- Volume
- 63
- Category
- Article
- ISSN
- 0022-4790
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β¦ Synopsis
Background:
The pharmacokinetics of dacarbazine (DTIC), which has been shown to be an effective therapeutic agent against metastatic melanoma, has not been extensively studied. However, to improve the clinical use of the drug, more information on the kinetics is required. Methods: A pharmacokinetic study was undertaken in six patients with melanoma of an extremity who were undergoing hyperthermic isolation perfusion with DTIC in order to understand better its clinical pharmacokinetics. Plasma was sampled from the arterial and venous lines of an extracorporeal pump during the perfusion with the systemic vein and urine sampled postperfusion. Samples were analyzed for DTIC, 2-azahypoxanthine (2-AZA), and aminoimidazole carboxamide (AIC). yymTc (Technetium) human serum albumin (HSA) was used in the perfusion circuit to monitor the crossover of the perfusate into the systemic circulation during the procedure. The data were analyzed using a compartmental model of sampled body compartments incorporating the isolated extremity.
Results: High tissue DTIC levels were maintained throughout the perfusion, whereas in the systemic circulation, plasma DTIC concentrations, when observed, were 4&100-fold less than those in the perfusate. Almost 70% of the DTIC administered was not recovered in the perfusate after the washout of the extremity. Conclusions: High levels of DTIC can be maintained in an extremity (i.e., arm or leg) during perfusion.
π SIMILAR VOLUMES
This paper reviews the changing concepts in the treatment of patients with malignant melanoma localized on the arm or leg. In addition to conventional surgical treatment, isolated regional perfusion of the extremities is discussed. An evaluation is presented of clinical and histological criteria app