title: Patient- and treatment-related factors associated with acute regional toxicity after isolated perfusion for melanoma of the extremities.
abstract: In order to gain some insight into the cause of acute regional toxicity after isolated perfusion using melphalan, 15 patient-related and perfusion-technique-related factors were tested in a logistic regression model. Acute toxicity was graded according to Wieberdink's grading system. In a group of 425 patients, 362 (85%) encountered no or slight toxicity with a grade I or II reaction, and 63 (15%) patients encountered more severe toxicity with a grade III, IV, or V reaction. Most patients were treated with a standard dose of 10 or 13 mg melphalan per liter of perfused tissue for leg and arm perfusions, respectively. Factors associated with a more severe toxicity reaction proved to be tissue temperatures of 40 degrees C or higher, female gender, a deterioration of the gas values of the venous perfusate during perfusion, and perfusion at a proximal level of isolation. Consideration of these prognostic factors may lead to a further decrease of acute regional toxicity in perfusion.
authors.affiliation: Department of Surgery, The Netherlands Cancer Institute, Amsterdam.
authors.forename: J M
authors.initials: JM
authors.lastname: Klaase
authors.forename: B B
authors.initials: BB
authors.lastname: Kroon
authors.forename: B N
authors.initials: BN
authors.lastname: van Geel
authors.forename: A M
authors.initials: AM
authors.lastname: Eggermont
authors.forename: H R
authors.initials: HR
authors.lastname: Franklin
authors.forename: G A
authors.initials: GA
authors.lastname: Hart
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001132:Arm; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D007866:Leg; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000188:drug therapy*; D008558:Melphalan / Q000008:administration & dosage* / Q000009:adverse effects*; D008875:Middle Aged; D012307:Risk Factors; D012878:Skin Neoplasms / Q000188:drug therapy*
chemical_list: D008558:Melphalan