Isolated limb perfusion using tumour necrosis factor a and melphalan in patients with advanced aggressive fibromatosis  

Oleh:

Broekhoven, D. L. M. van ; Deroose, J. P. ; Bonvalot, S. ; Gronchi, A. ; Grunhagen, D. J.

Jenis: Article from Article - diterbitkan di jurnal ilmiah internasional
Dalam koleksi: BJS: British Journal of Surgery vol. 101 no. 13 (Dec. 2014), page 1674-1680.

Ketersediaan

Perpustakaan FK Nomor Panggil: B15.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background Aggressive fibromatoses (desmoid tumours) may be locally aggressive, but do not metastasize. Although a conservative approach is advocated for most patients, pain and functional impairment are indications for active treatment. Tumour necrosis factor (TNF) a and melphalan-based isolated limb perfusion (TM-ILP) is a limb-saving treatment modality for soft tissue tumours. This study reports the results of TM-ILP treatment in patients with aggressive fibromatosis. Methods Institutional databases of three European centres were searched. All patients who received TM-ILP treatment for aggressive fibromatosis between 1990 and 2012 were included. Before therapy, the patients were discussed at multidisciplinary tumour board meetings. Results Twenty-five patients received 28 TM-ILP treatments. The median age of patients was 28 (i.q.r. 19–34) years and median hospital stay was 8 (7–12) days. Median follow-up was 84 (34–114) months. A complete response was achieved after two TM-ILP treatments, and a partial response after 17 treatments in 16 patients. Stable disease was reported after eight treatments in seven patients, including a patient with stable disease after the first treatment and progression after the second TM-ILP. Toxicity was modest after most treatments; Wieberdink grade IV (extensive epidermolysis, and threatening or manifest compartment syndrome) was seen after two TM-ILP treatments. Systemic leakage was reported after one treatment, but did not lead to systemic toxicity. Functional outcome was good; 16 patients had no physical limitations, and six patients had some limitations but did not need medical aids. Amputation was prevented in all but three patients. Conclusion TNF-a-based ILP is effective in patients with aggressive fibromatosis.

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