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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2009

01-04-2009 | Melanomas

Optimizing Melphalan Pharmacokinetics in Regional Melanoma Therapy: Does Correcting for Ideal Body Weight Alter Regional Response or Toxicity?

Authors: N. McMahon, BS, T. Y. Cheng, MD, G. M. Beasley, MD, I. Spasojevic, PhD, W. Petros, PhD, C. K. Augustine, PhD, P. Zipfel, PhD, J. C. Padussis, MD, G. Sanders, BSN, Douglas S. Tyler, MD

Published in: Annals of Surgical Oncology | Issue 4/2009

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Abstract

Background

This study aims to determine what effect correcting melphalan dosing for ideal body weight (IBW) has on toxicity and response in isolated limb infusion (ILI) in patients with advanced extremity melanoma.

Methods

This was an open observational study examining whether correcting the melphalan dose for IBW will influence response and toxicity in patients undergoing ILI for advanced extremity melanoma in 41 patients undergoing 42 procedures (13 without correction for IBW; and 29 with correction for IBW). Melphalan pharmacokinetics, limb toxicity, serologic toxicity, and response at 3 months were compared.

Results

The corrected group had a lower estimated limb volume (V esti) to melphalan volume at steady state (V ss) (P < .0001) ratio as well as lower incidence of grade ≥3 regional toxicity, serologic toxicity, and compartment syndrome (P = .0249, P = .027, P = .02). There was a positive correlation of V esti/V ss to toxicity (P = .0127, r = .382). No significant difference in response (P = .3609) between the groups was found, although there was a trend of association between V esti/V ss and response (P = .051, r = .3383).

Conclusions

Correcting for IBW in ILI lowers toxicity without significantly altering response rates.
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Metadata
Title
Optimizing Melphalan Pharmacokinetics in Regional Melanoma Therapy: Does Correcting for Ideal Body Weight Alter Regional Response or Toxicity?
Authors
N. McMahon, BS
T. Y. Cheng, MD
G. M. Beasley, MD
I. Spasojevic, PhD
W. Petros, PhD
C. K. Augustine, PhD
P. Zipfel, PhD
J. C. Padussis, MD
G. Sanders, BSN
Douglas S. Tyler, MD
Publication date
01-04-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-0288-1

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