title: Transarterial chemoembolization of liver metastases in patients with uveal melanoma.
abstract: 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.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Klinikum Darmstadt, Darmstadt, Germany. huppert@klinikum-darmstadt.de
authors.forename: P E
authors.initials: PE
authors.lastname: Huppert
authors.forename: G
authors.initials: G
authors.lastname: Fierlbeck
authors.forename: P
authors.initials: P
authors.lastname: Pereira
authors.forename: S
authors.initials: S
authors.lastname: Schanz
authors.forename: S H
authors.initials: SH
authors.lastname: Duda
authors.forename: H
authors.initials: H
authors.lastname: Wietholtz
authors.forename: C
authors.initials: C
authors.lastname: Rozeik
authors.forename: C D
authors.initials: CD
authors.lastname: Claussen
mesh_terms: 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*
chemical_list: D006490:Hemostatics; D011142:Polyvinyl Alcohol