Transarterial chemoembolization of liver metastases in patients with uveal melanoma.
Metastases from uveal melanoma are often confined to the liver. Palliative hepatic chemoembolization has been considered to be a reasonable treatment approach. We enrolled 14 patients with hepatic metastases from uveal melanoma into a pilot trial of transarterial chemoembolization (TACE). All patients received additional systemic immuno-chemotherapy or best supportive care. In 31 procedures 100mg/m(2) of cisplatine was continuously infused by means of a power injector preceding embolization by manual injection of polyvinyl alcohol particles. In three procedures cisplatine was replaced by 200mg/m(2) carboplatine because of increased serum creatinine levels. Tumor response was evaluated using RECIST criteria. Fourteen patients received 34 TACE's (mean: 2.4 treatments). Eight patients (57%) achieved partial response (PR), four patients (29%) had stable disease and two patients (14%) tumor progression. Median time to progression was 8.5 months (5-35 months). Median survival after first TACE was 14.5 months in responders compared to 10 months in non-responders (p=0.18, not significant) and 11.5 months (3-69 months) in all patients. In seven patients with metastases occupying less than 25% of liver volume median survival was 17 months compared to 11 months in seven patients with tumor involvement of more than 25% (p=0.02) with partial response rate of 86% and 29%, respectively. TACE of liver metastases from uveal melanoma is well tolerated and may prolong survival in patients with limited tumor extension.
Huppert
P E
PE
Department of Diagnostic and Interventional Radiology, Klinikum Darmstadt, Darmstadt, Germany. huppert@klinikum-darmstadt.de
Fierlbeck
G
G
Pereira
P
P
Schanz
S
S
Duda
S H
SH
Wietholtz
H
H
Rozeik
C
C
Claussen
C D
CD
D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000556:secondary*; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary*; D010865:Pilot Projects; D011142:Polyvinyl Alcohol / Q000627:therapeutic use*; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000175:diagnosis / Q000188:drug therapy*
D006490:Hemostatics; D011142:Polyvinyl Alcohol