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Lobato FS, Libotte GB, Platt GM. Optimization of hyperthermia process applied to cancer treatment using multi-objective optimization differential evolution. J Therm Biol 2023; 111:103400. [PMID: 36585079 DOI: 10.1016/j.jtherbio.2022.103400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 10/22/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
Due to the number of cancer cases diagnosed each year and the fatality rate resulting from some more severe types, the improvement of less invasive and more efficient treatment techniques is of great importance. In this context, hyperthermia is a medical procedure in which the tumor region is heated by using an applicator for a certain period, aiming to destroy pathological cells. Computational models can be used to simulate the heating effect of tumors and adjacent cells. In general, the solution to an optimization problem considering factors such as heating temperature, applicator position, and the time in which the region will be subjected to heating can provide important information about the procedure. Traditionally, this type of problem has been addressed in a single objective context, focusing on minimizing the destruction of adjacent healthy tissue considering the area of the applicator constant. Our fundamental objective is to propose a multi-objective design problem considering the minimization of the area subject to the procedure and the time required for the process of hyperthermia in a breast cancer treatment. The problem is constrained by the degree of tissue destruction and by a partial differential equation that describes the phenomenon of heat transfer in both healthy and tumor tissues. The results obtained demonstrate that a point with a good compromise between the objectives can be chosen in such a way that a particular strategy can be defined for each patient.
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Affiliation(s)
- Fran Sérgio Lobato
- Chemical Engineering Faculty, Federal University of Uberlândia, Uberlândia, Brazil.
| | - Gustavo Barbosa Libotte
- Department of Computational Modeling, Polytechnic Institute, Rio de Janeiro State University, Nova Friburgo, Brazil.
| | - Gustavo Mendes Platt
- School of Chemistry and Food, Federal University of Rio Grande, Santo Antônio da Patrulha, Brazil.
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Mendell JR, Chicoine LG, Al-Zaidy SA, Sahenk Z, Lehman K, Lowes L, Miller N, Alfano L, Galliers B, Lewis S, Murrey D, Peterson E, Griffin DA, Church K, Cheatham S, Cheatham J, Hogan MJ, Rodino-Klapac LR. Gene Delivery for Limb-Girdle Muscular Dystrophy Type 2D by Isolated Limb Infusion. Hum Gene Ther 2019; 30:794-801. [PMID: 30838895 PMCID: PMC6648191 DOI: 10.1089/hum.2019.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/21/2019] [Indexed: 01/16/2023] Open
Abstract
In a previous limb-girdle muscular dystrophy type 2D (LGMD2D) clinical trial, robust alpha-sarcoglycan gene expression was confirmed following intramuscular gene (SGCA) transfer. This paved the way for first-in-human isolated limb infusion (ILI) gene transfer trial to the lower limbs. Delivery of scAAVrh74.tMCK.hSGCA via an intravascular route through the femoral artery predicted improved ambulation. This method was initially chosen to avoid safety concerns required for large systemic vascular delivery viral loads. ILI methods were adopted from the extensive chemotherapy experience for treatment of malignancies confined to the extremities. Six LGMD2D subjects were enrolled in a dose-ascending open-label clinical trial. Safety of the procedure was initially assessed in the single limb of a non-ambulant affected adult at a dose of 1 × 1012 vg/kg. Subsequently, ambulatory children (aged 8-13 years) were enrolled and dosed bilaterally with either 1 × 1012 vg/kg/limb or 3 × 1012 vg/kg/limb. The six-minute walk test (6MWT) served as the primary clinical outcome; secondary outcomes included muscle strength (maximum voluntary isometric force testing) and SGCA expression at 6 months. All ambulatory participants except one had pre- and post-treatment muscle biopsies. All four subjects biopsied had confirmed SGCA gene delivery by immunofluorescence, Western blot analysis (14-25% of normal), and vector genome copies (5.4 × 103-7.7 × 104 vg/μg). Muscle strength in the knee extensors (assessed by force generation in kilograms) showed improvement in two subjects that correlated with an increase in fiber diameter post gene delivery. Six-minute walk times decreased or remained the same. Vascular delivery of AAVrh74.tMCK.hSGCA was effective at producing SGCA protein at low doses that correlated with vector copies and local functional improvement restricted to targeted muscles. Future trials will focus on systemic administration to enable targeting of proximal muscles to maximize clinical benefit.
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Affiliation(s)
- Jerry R. Mendell
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, Columbus, Ohio
- Department of Neurology, The Ohio State University, Columbus, Ohio
| | - Louis G. Chicoine
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, Columbus, Ohio
| | | | - Zarife Sahenk
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, Columbus, Ohio
- Department of Neurology, The Ohio State University, Columbus, Ohio
| | - Kelly Lehman
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Linda Lowes
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, Columbus, Ohio
- Department of Neurology, The Ohio State University, Columbus, Ohio
| | - Natalie Miller
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Lindsay Alfano
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Neurology, The Ohio State University, Columbus, Ohio
| | - Beverly Galliers
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Sarah Lewis
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Darren Murrey
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Ellyn Peterson
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Danielle A. Griffin
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Kathleen Church
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Sharon Cheatham
- Department of Interventional Cardiology, The Ohio State University, Columbus, Ohio
| | - John Cheatham
- Department of Interventional Cardiology, The Ohio State University, Columbus, Ohio
| | - Mark J. Hogan
- Department of Radiology, Vascular and Interventional Radiology, Nationwide Children's Hospital, Columbus, Ohio
| | - Louise R. Rodino-Klapac
- Center for Gene Therapy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
- Department of Pediatrics, The Ohio State University, Columbus, Ohio
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Read T, Lonne M, Sparks DS, David M, Wagels M, Schaider H, Soyer HP, Smithers BM. A systematic review and meta‐analysis of locoregional treatments for in‐transit melanoma. J Surg Oncol 2019; 119:887-896. [DOI: 10.1002/jso.25400] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 01/13/2019] [Accepted: 01/19/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Tavis Read
- Queensland Melanoma Project, Princess Alexandra HospitalBrisbane Queensland Australia
- The University of Queensland, Faculty of Medicine, Princess Alexandra HospitalBrisbane Queensland Australia
- Griffith University, School of MedicineGold Coast Queensland Australia
| | - Michael Lonne
- The University of Queensland, Faculty of Medicine, Princess Alexandra HospitalBrisbane Queensland Australia
| | - David S. Sparks
- The University of Queensland, Faculty of Medicine, Princess Alexandra HospitalBrisbane Queensland Australia
| | - Michael David
- The University of Queensland, School of Health and Rehabilitation SciencesBrisbane Queensland Australia
- The University of Newcastle, School of Medicine and Public HealthNewcastle New South Wales Australia
| | - Michael Wagels
- Queensland Melanoma Project, Princess Alexandra HospitalBrisbane Queensland Australia
- The University of Queensland, Faculty of Medicine, Princess Alexandra HospitalBrisbane Queensland Australia
| | - Helmut Schaider
- The University of Queensland, Dermatology Research CentreBrisbane Queensland Australia
| | - H. Peter Soyer
- The University of Queensland, Dermatology Research CentreBrisbane Queensland Australia
| | - B. Mark Smithers
- Queensland Melanoma Project, Princess Alexandra HospitalBrisbane Queensland Australia
- The University of Queensland, Faculty of Medicine, Princess Alexandra HospitalBrisbane Queensland Australia
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Nabil M, Decuzzi P, Zunino P. Modelling mass and heat transfer in nano-based cancer hyperthermia. ROYAL SOCIETY OPEN SCIENCE 2015; 2:150447. [PMID: 26587251 PMCID: PMC4632523 DOI: 10.1098/rsos.150447] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 09/24/2015] [Indexed: 05/26/2023]
Abstract
We derive a sophisticated mathematical model for coupled heat and mass transport in the tumour microenvironment and we apply it to study nanoparticle delivery and hyperthermic treatment of cancer. The model has the unique ability of combining the following features: (i) realistic vasculature; (ii) coupled capillary and interstitial flow; (iii) coupled capillary and interstitial mass transfer applied to nanoparticles; and (iv) coupled capillary and interstitial heat transfer, which are the fundamental mechanisms governing nano-based hyperthermic treatment. This is an improvement with respect to previous modelling approaches, where the effect of blood perfusion on heat transfer is modelled in a spatially averaged form. We analyse the time evolution and the spatial distribution of particles and temperature in a tumour mass treated with superparamagnetic nanoparticles excited by an alternating magnetic field. By means of numerical experiments, we synthesize scaling laws that illustrate how nano-based hyperthermia depends on tumour size and vascularity. In particular, we identify two distinct mechanisms that regulate the distribution of particle and temperature, which are characterized by perfusion and diffusion, respectively.
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Affiliation(s)
- M. Nabil
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - P. Decuzzi
- Department of Translational Imaging, Houston Methodist Research Institute, Houston, TX, USA
| | - P. Zunino
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA, USA
- Modeling and Scientific Computing (MOX), Department of Mathematics, Politecnico di Milano, Milan, Italy
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Abstract
In-transit melanoma is an uncommon pattern of recurrence, but presents unique management challenges and opportunities for treatment. The clinical presentation usually involves from 1 to more than 100 small subcutaneous or cutaneous nodules, ranging from submillimeter to multiple centimeters in diameter. Regional chemotherapy techniques are a mainstay of treatment of patients without systemic disease spread. Future applications of regional therapy are likely to involve combination therapy with cytotoxic agents and novel immune modulators. Regional therapy provides distinct opportunities for the treatment of unresectable disease, and offers a unique platform for investigation of novel therapeutics in early-stage clinical trials.
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Affiliation(s)
- Paul J Speicher
- Department of Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710, USA
| | - Claire H Meriwether
- Department of Surgery, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710, USA
| | - Douglas S Tyler
- Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
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Ruschulte H, Shi S, Tseng WW, Kolodzie K, Crawford PC, Schneider DB, Kashani-Sabet M, Minor D, Apfel C, Leong SP. Anesthesia management of patients undergoing hyperthermic isolated limb perfusion with melphalan for melanoma treatment: an analysis of 17 cases. BMC Anesthesiol 2013; 13:15. [PMID: 23865420 PMCID: PMC3726295 DOI: 10.1186/1471-2253-13-15] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 07/11/2013] [Indexed: 02/07/2023] Open
Abstract
Background Hyperthermic isolated limb perfusion (HILP) is used for patients with intractable or extensive in-transit metastatic melanoma of the limb to deliver high concentrations of cytotoxic agents to the affected limb and offers a treatment option in a disease stage with a poor prognosis when no treatment is given. Methods In a retrospective chart review of 17 cases, we studied the anesthetic and hemodynamic changes during HILP and its management. Results HILP was well tolerated except in one case that is described herein. We present summary data of all cases undergoing upper and lower limb perfusion, discuss our current clinical practice of preoperative, perioperative and intraoperative patient care including the management of HILP circuit. Conclusion HILP is a challenging procedure, and requires a team effort including the surgical team, anesthesia care providers, perfusionists and nurses. Intraoperatively, invasive hemodynamic and metabolic monitoring is indispensable to manage significant hemodynamic and metabolic changes due to fluid shifts and release of cytokines.
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Affiliation(s)
- Heiner Ruschulte
- Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA.
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Cervadoro A, Giverso C, Pande R, Sarangi S, Preziosi L, Wosik J, Brazdeikis A, Decuzzi P. Design maps for the hyperthermic treatment of tumors with superparamagnetic nanoparticles. PLoS One 2013; 8:e57332. [PMID: 23451208 PMCID: PMC3581487 DOI: 10.1371/journal.pone.0057332] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 01/18/2013] [Indexed: 11/19/2022] Open
Abstract
A plethora of magnetic nanoparticles has been developed and investigated under different alternating magnetic fields (AMF) for the hyperthermic treatment of malignant tissues. Yet, clinical applications of magnetic hyperthermia are sporadic, mostly due to the low energy conversion efficiency of the metallic nanoparticles and the high tissue concentrations required. Here, we study the hyperthermic performance of commercially available formulations of superparamagnetic iron oxide nanoparticles (SPIOs), with core diameter of 5, 7 and 14 nm, in terms of absolute temperature increase ΔT and specific absorption rate (SAR). These nanoparticles are operated under a broad range of AMF conditions, with frequency f varying between 0.2 and 30 MHz; field strength H ranging from 4 to 10 kA m(-1); and concentration cMNP varying from 0.02 to 3.5 mg ml(-1). At high frequency field (∼30 MHz), non specific heating dominates and ΔT correlates with the electrical conductivity of the medium. At low frequency field (<1 MHz), non specific heating is negligible and the relaxation of the SPIO within the AMF is the sole energy source. We show that the ΔT of the medium grows linearly with cMNP , whereas the SARMNP of the magnetic nanoparticles is independent of cMNP and varies linearly with f and H(2) . Using a computational model for heat transport in a biological tissue, the minimum requirements for local hyperthermia (Ttissue >42°C) and thermal ablation (Ttissue >50°C) are derived in terms of cMNP , operating AMF conditions and blood perfusion. The resulting maps can be used to rationally design hyperthermic treatments and identifying the proper route of administration - systemic versus intratumor injection - depending on the magnetic and biodistribution properties of the nanoparticles.
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Affiliation(s)
- Antonio Cervadoro
- Department of Translational Imaging, The Methodist Hospital Research Institute, Houston, Texas, United States of America
- Department of Mechanics, Politecnico di Torino, Turin, Italy
| | - Chiara Giverso
- Department of Mathematical Sciences, Politecnico di Torino, Turin, Italy
| | - Rohit Pande
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, United States of America
- Texas Superconductivity Center, Houston, Texas, United States of America
| | - Subhasis Sarangi
- Texas Superconductivity Center, Houston, Texas, United States of America
| | - Luigi Preziosi
- Department of Mathematical Sciences, Politecnico di Torino, Turin, Italy
| | - Jarek Wosik
- Department of Electrical and Computer Engineering, University of Houston, Houston, Texas, United States of America
- Texas Superconductivity Center, Houston, Texas, United States of America
| | - Audrius Brazdeikis
- Texas Superconductivity Center, Houston, Texas, United States of America
- Department of Physics, University of Houston, Houston, Texas, United States of America
| | - Paolo Decuzzi
- Department of Translational Imaging, The Methodist Hospital Research Institute, Houston, Texas, United States of America
- Department of Experimental and Clinical Medicine, University of “Magna Graecia”, Catanzaro, Italy
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Beasley GM, Coleman AP, Raymond A, Sanders G, Selim MA, Peterson BL, Brady MS, Davies MA, Augustine C, Tyler DS. A phase I multi-institutional study of systemic sorafenib in conjunction with regional melphalan for in-transit melanoma of the extremity. Ann Surg Oncol 2012; 19:3896-3905. [PMID: 22549288 DOI: 10.1245/s10434-012-2373-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Indexed: 12/15/2022]
Abstract
BACKGROUND Isolated limb infusion with melphalan (ILI-M) corrected for ideal body weight (IBW) is a well-tolerated treatment for patients with in-transit extremity melanoma with an approximate 29 % complete response (CR) rate. Sorafenib, a multi-kinase inhibitor, has been shown to augment tumor response to chemotherapy in preclinical studies. METHODS A multi-institutional, dose-escalation, phase I study was performed to evaluate the safety and antitumor activity of sorafenib in combination with ILI-M. Patients with AJCC stage IIIB/IIIC/IV melanoma were treated with sorafenib starting at 400 mg daily for 7 days before and 7 days after ILI-M corrected for IBW. Toxicity, drug pharmacokinetics, and tumor protein expression changes were measured and correlated with clinical response at 3 months. RESULTS A total of 20 patients were enrolled at two institutions. The maximum tolerated dose (MTD) of sorafenib in combination with ILI-M was 400 mg. Four dose-limiting toxicities occurred, including soft tissue ulcerations and compartment syndrome. There were three CRs (15 %) and four partial responses (20 %). Of patients with the Braf mutation, 83 % (n = 6) progressed compared with only 33 % without (n = 12). Short-term sorafenib treatment did alter protein expression as measured with reverse phase protein array (RPPA) analysis, but did not inhibit protein expression in the MAP kinase pathway. Sorafenib did not alter melphalan pharmacokinetics. CONCLUSION This trial defined the MTD of systemically administered sorafenib in combination with ILI-M. Although some responses were seen, the addition of sorafenib to ILI-M did not appear to augment the effects of melphalan but did increase regional toxicity.
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Affiliation(s)
- G M Beasley
- Department of Surgery, Duke University, Durham, NC
| | - A P Coleman
- Department of Surgery, Duke University, Durham, NC
| | - A Raymond
- Department of Surgery, Duke University, Durham, NC
| | - G Sanders
- Department of Surgery, Duke University, Durham, NC
| | - M A Selim
- Department of Pathology, Duke University, Durham, NC
| | - B L Peterson
- Cancer Center Biostatistics, Duke University, Durham, NC
| | - M S Brady
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York
| | - M A Davies
- Department of Melanoma Medical Oncology, MD Anderson Cancer Center, Houston, Texas.,Department of Systems Biology, MD Anderson Cancer Center, Houston, Texas
| | - C Augustine
- Department of Surgery, Duke University, Durham, NC.,VA Medical Center, Durham, NC
| | - D S Tyler
- Department of Surgery, Duke University, Durham, NC.,VA Medical Center, Durham, NC
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Sharma K, Beasley G, Turley R, Raymond AK, Broadwater G, Peterson B, Mosca P, Tyler D. Patterns of Recurrence Following Complete Response to Regional Chemotherapy for In-Transit Melanoma. Ann Surg Oncol 2012; 19:2563-71. [DOI: 10.1245/s10434-012-2315-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Indexed: 01/27/2023]
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Ashton KS. Nursing care of patients undergoing isolated limb procedures for recurrent melanoma of the extremity. J Perianesth Nurs 2012; 27:94-109. [PMID: 22443922 DOI: 10.1016/j.jopan.2012.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 11/15/2011] [Accepted: 01/12/2012] [Indexed: 11/17/2022]
Abstract
Isolated limb perfusion and isolated limb infusion are surgical interventions that provide high-dose regional chemotherapy to patients experiencing a recurrence of melanoma in an extremity. Nurses may be unfamiliar with these treatment options, as they are not available in all hospitals; however, the number of people diagnosed with melanoma is increasing. It is important for nurses to understand these surgical procedures to provide safe high-quality care before and after the surgery. Currently, there are several gaps in our knowledge about patients' experiences or nurse-sensitive outcomes. There are abundant opportunities for nurses to improve the care of patients who undergo surgical interventions to manage melanoma in the extremity.
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Affiliation(s)
- Kathleen S Ashton
- School of Nursing, The University of North Carolina at Greensboro, Greensboro, NC, USA.
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Abstract
In general, patients with stage IV melanoma have poor survival. However, there are subsets of stage IV melanoma patients who are candidates for surgical debulking. There is a growing body of retrospective evidence about clinicians being able to better select patients who may benefit from surgical resection in isolated stage IV disease. In addition, palliative-type resections may improve quality of life in selected cases. In this article, we discuss how recent advances in effective systemic therapies for melanoma may impact the clinical use of debulking surgery in melanoma patients. We also review the available literature about the rationale, risks, benefits and selection of patients for these procedures.
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Affiliation(s)
- Csaba Gajdos
- Department of Surgery, University of Colorado at Denver, Mail Stop C313, 12631 East 17th Avenue, Aurora, CO 80045, USA.
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Current World Literature. Curr Opin Support Palliat Care 2010; 4:293-304. [DOI: 10.1097/spc.0b013e328340e983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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