Hepatic artery infusion of melphalan in patients with liver metastases from ocular melanoma.

Abstract:

BACKGROUND AND OBJECTIVES:Ocular melanoma has a predilection for liver metastases. Systemic treatment is ineffective and the optimal regional therapy approach is poorly defined. Isolated hepatic perfusion (IHP) with melphalan has emerged as a viable treatment option, however a subset of patients are not candidates for this treatment. We therefore sought to determine if melphalan could be safely administered via the hepatic artery for these patients. METHODS:A retrospective review of patients treated with hepatic artery infusion (HAI) of melphalan was undertaken. All patients had contraindications to IHP and were without other therapy options. Melphalan infusion was repeated every four weeks with consideration for dose escalation in the absence of toxicity or significant disease progression. RESULTS:Fourteen patients were treated with HAI of melphalan from 2010 to 2015. All patients had hepatic dysfunction or prohibitive tumor volume precluding IHP. There were no procedure-related complications. Three patients (21%) died within 30 days and the median survival was 2.9 months. Elevated baseline bilirubin > 2.5 mg/dL was associated with worse overall survival (0.93 vs 6.3 months, P < 0.05). CONCLUSION:HAI of melphalan is safe and feasible for patients with metastatic ocular melanoma. Further study to determine the optimal utilization of this treatment approach is warranted.

journal_name

J Surg Oncol

authors

Boone BA,Perkins S,Bandi R,Santos E,McCluskey K,Bartlett DL,Pingpank JF

doi

10.1002/jso.24984

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

940-946

issue

5

eissn

0022-4790

issn

1096-9098

journal_volume

117

pub_type

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