1
|
Algarin YA, Pulumati A, Jaalouk D, Tan J, Zeitouni NC, Nouri K. The palliative role of lasers in the treatment of melanoma. Arch Dermatol Res 2024; 316:244. [PMID: 38795247 PMCID: PMC11127800 DOI: 10.1007/s00403-024-03107-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 02/06/2024] [Accepted: 04/26/2024] [Indexed: 05/27/2024]
Abstract
Melanoma, accounting for a significant proportion of skin cancer-related deaths, has variable survival outcomes based on the stage at diagnosis and treatment efficacy. Traditional treatments, while effective, pose risks of scarring and systemic side effects. Laser therapy offers an emerging non-surgical alternative, with CO2 lasers particularly showing promise in palliative care.A comprehensive search was conducted using PubMed, focusing on laser therapy for melanoma treatment. The search included studies on both stand-alone and adjunct laser therapies, with inclusion criteria requiring peer-reviewed articles detailing treatment outcomes for primary, recurrent, or metastatic melanoma.The literature shows that laser therapy for melanoma falls into four major types when categorized by laser medium: solid-state, diode, pulse-dye, and gas (CO2). Data on solid-state lasers for melanoma are limited and their use remains controversial. However, one study with high-energy pulsed neodymium lasers reported a 5-year survival of 82.9% with minimal adverse effects for primary melanoma. CO2 laser therapy has been effective for palliative treatment, with one study showing 54.8% of patients with recurrent melanoma surviving 5.4 years post-ablation. For metastatic melanoma, numerous studies have shown that CO2 laser therapy can provide symptomatic relief and disease control. Combination therapies using lasers and immune-based therapies have demonstrated enhanced outcomes and immune activation, highlighting the potential of laser therapies in melanoma management.While traditional treatments remain the standard for primary melanoma, laser therapies, particularly CO2 laser ablation, show substantial promise in palliative care for metastatic melanoma. Careful patient selection and assessment are crucial for achieving positive outcomes.
Collapse
Affiliation(s)
- Yanci A Algarin
- Eastern Virginia Medical School, Norfolk, VA, USA.
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
| | - Anika Pulumati
- University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Dana Jaalouk
- Florida State University College of Medicine, Tallahassee, FL, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Jiali Tan
- Albany Medical College, Albany, NY, USA
| | - Nathalie C Zeitouni
- Medical Dermatology Specialists, University of Arizona COM Phoenix, Arizona, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
2
|
Nijhuis A, Chung D, London K, Uren R, Thompson J, Nieweg O. Ultrasound Examination of the Lymphatic Drainage Area and Regional Lymph Nodes in Melanoma Patients with In-Transit Metastases. Ann Surg Oncol 2020; 28:1625-1631. [PMID: 33108596 DOI: 10.1245/s10434-020-09240-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/24/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND In-transit metastases (ITMs) are cutaneous or subcutaneous regional metastases that may occur in patients with melanoma. ITMs are often multiple and new lesions tend to appear over time. Ultrasonography can detect impalpable subcutaneous tumors. OBJECTIVE The aim of this study was to assess the value of ultrasound examination in detecting additional, non-palpable ITMs and to determine their relevance. METHODS Melanoma patients with ITMs who underwent regional ultrasound examination of the skin and subcutaneous tissue between the wide excision scar of the primary melanoma and the regional lymph node field were identified. In most, ultrasound assessment also included the regional lymph node field. Relevant data were collected and analyzed. RESULTS Twenty-eight patients presenting with a total of 40 ITMs were included. Ultrasound examination identified additional ITMs in 15 patients (54%). No nodal recurrences were detected. Most additional lesions were found closer to the regional lymph nodes than the original ITMs. Management was influenced by the ultrasound findings in nine patients (32%), five of whom had more extensive surgery, three received systemic drug therapy instead of surgery, and in one patient surgery was delayed and follow-up intensified. In one patient, only subcutaneous fat was found in the excised specimen and the ultrasound was classified as false-positive. CONCLUSION In melanoma patients with ITMs, ultrasonography of the lymphatic drainage area provided valuable information, as additional ITMs were identified in more than half of these patients and management was influenced in one-third.
Collapse
Affiliation(s)
- Amanda Nijhuis
- Melanoma Institute Australia, Sydney, NSW, Australia. .,Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - David Chung
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Alfred Nuclear Medicine and Ultrasound, The University of Sydney, Sydney, NSW, Australia
| | - Kevin London
- Alfred Nuclear Medicine and Ultrasound, The University of Sydney, Sydney, NSW, Australia.,Department of Nuclear Medicine, Westmead Hospital, Westmead, NSW, Australia
| | - Roger Uren
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Alfred Nuclear Medicine and Ultrasound, The University of Sydney, Sydney, NSW, Australia
| | - John Thompson
- Melanoma Institute Australia, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Omgo Nieweg
- Melanoma Institute Australia, Sydney, NSW, Australia.,Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| |
Collapse
|
3
|
Vrielink OM, Kruijff S, van Leeuwen BL, Roodenburg JL. Application of CO 2 laser evaporation in locally advanced melanoma. Melanoma Manag 2019; 6:MMT14. [PMID: 31236206 PMCID: PMC6582456 DOI: 10.2217/mmt-2018-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/18/2019] [Indexed: 11/21/2022] Open
Abstract
Aim This study aims to investigate the role of CO2 laser evaporation in the treatment of melanoma patients with satellite or in-transit metastases. Materials & methods Patients who underwent CO2 laser evaporation were retrospectively included between November 2002 and August 2018. The Sharplan 40C CO2 laser was used with a high pulse wave mode. Data concerning patient and tumor characteristics, CO2 laser evaporation and subsequent therapies were collected. Results A total of 26 patients were included. Median duration of local control was 5.5 months. The median number of lesions evaporated per treatment was three (1-16); patients received a median of three (1-19) treatments. Conclusion In a selected group of melanoma patients with satellite or in-transit metastases, CO2 laser evaporation should be considered as treatment for local control.
Collapse
Affiliation(s)
- Otis M Vrielink
- Department of Surgery, Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Surgery, Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Schelto Kruijff
- Department of Surgery, Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Surgery, Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Barbara L van Leeuwen
- Department of Surgery, Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Surgery, Division of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Ln Roodenburg
- Department of Oral & Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Oral & Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
4
|
Orero A, Roé N, Muxí A, Rubí S, Duch J, Rull R, Pavón N, Pons F, Pavía J, Vidal-Sicart S. Monitoring system for isolated limb perfusion based on a portable gamma camera. Nuklearmedizin 2018; 48:166-72. [DOI: 10.3413/nukmed-0223] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 05/05/2009] [Indexed: 11/20/2022]
Abstract
Summary
Background: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-α) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular territory. Leakage is currently controlled by using radiotracers and heavy external probes in a procedure that requires continuous manual calculations. The aim of this work was to develop a light, easily transportable system to monitor limb perfusion leakage by controlling systemic blood pool radioactivity with a portable gamma camera adapted for intraoperative use as an external probe, and to initiate its application in the treatment of MM patients. Methods: A special collimator was built for maximal sensitivity. Software for acquisition and data processing in real time was developed. After testing the adequacy of the system, it was used to monitor limb perfusion leakage in 16 patients with malignant melanoma to be treated with perfusion of TNF-α and melphalan. Results: The field of view of the detector system was 13.8 cm, which is appropriate for the monitoring, since the area to be controlled was the precordial zone. The sensitivity of the system was 257 cps/MBq. When the percentage of leakage reaches 10% the associated absolute error is ± 1%. After a mean follow-up period of 12 months, no patients have shown any significant or lasting side-effects. Partial or complete remission of lesions was seen in 9 out of 16 patients (56%) after HILP with TNF-α and melphalan. Conclusion: The detector system together with specially developed software provides a suitable automatic continuous monitoring system of any leakage that may occur during limb perfusion. This technique has been successfully implemented in patients for whom perfusion with TNF-α and melphalan has been indicated.
Collapse
|
5
|
Cecchini S, Sarti D, Ricci S, Vergini LD, Sallei M, Serresi S, Ricotti G, Mulazzani L, Lattanzio F, Fiorentini G. Isolated limb infusion chemotherapy with or without hemofiltration for recurrent limb melanoma. World J Clin Oncol 2015; 6:57-63. [PMID: 26266102 PMCID: PMC4530379 DOI: 10.5306/wjco.v6.i4.57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/19/2015] [Accepted: 06/16/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To better define the efficacy and the safety of intra-arterial infusion performed with or without hemofiltration for recurrent limb melanoma.
METHODS: Patients with the following characteristics were included in the study: recurrent limb melanoma not indicated for surgical resection, measurable disease in the extremity, > 18 years, performances status (Eastern Cooperative Oncology Group ) was 0-1 and life expectancy of at least 6 mo. Twenty nine consecutive patients were enrolled in the study. Patients underwent fluoroscopic placement of angiographic arterial and venous catheters to infuse the drug in the artery [isolated limb infusion (ILI)], and to stop the out flow (venous). Melphalan was rapidly infused into the isolated limb via the arterial catheter after the inflation of venous balloon catheter. Then the circulation of the limb was completely blocked with a pneumatic cuff at the root of the limb. Haemofiltration (HF) was available only in the main center, and was performed with an extracorporeal perfusion system, in order to reduce high systemic toxic peaks of drug.
RESULTS: Thirty seven ILI were done in 29 cases (31 ILI-HF and 6 ILI) between 2001 and 2014 at Ancona and Pesaro Hospitals, Italy. Clinical outcomes were monitored 30 d after treatment. Eleven patients (38%) received infusion of melphalan alone, 7 (24%) melphalan associated to mitomicin C and 7 (24%) melphalan associated to cisplatin, the remaining 4 were treated with cisplatin, melphalan and epirubicin or cisplatin and mitomicin C. The overall response rate was 66%, in particular, 3 patients (10%) were complete responders and 16 (56%) were partial responders; whereas 7 patients (24%) had stable disease, and 3 (10%) showed progressive disease. Limb toxicity was assessed adopting Wieberdink scale, with evidence of 90% of low grade (I and II) toxicity.
CONCLUSION: ILI-HF and ILI are effective and safe treatments for recurrent non-resectable limb melanoma. They present evidence of favorable clinical benefit and is effective in delaying progression.
Collapse
|
6
|
|
7
|
Stawikowski MJ, Aukszi B, Stawikowska R, Cudic M, Fields GB. Glycosylation modulates melanoma cell α2β1 and α3β1 integrin interactions with type IV collagen. J Biol Chem 2014; 289:21591-604. [PMID: 24958723 PMCID: PMC4118119 DOI: 10.1074/jbc.m114.572073] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/20/2014] [Indexed: 01/02/2023] Open
Abstract
Although type IV collagen is heavily glycosylated, the influence of this post-translational modification on integrin binding has not been investigated. In the present study, galactosylated and nongalactosylated triple-helical peptides have been constructed containing the α1(IV)382-393 and α1(IV)531-543 sequences, which are binding sites for the α2β1 and α3β1 integrins, respectively. All peptides had triple-helical stabilities of 37 °C or greater. The galactosylation of Hyl(393) in α1(IV)382-393 and Hyl(540) and Hyl(543) in α1(IV)531-543 had a dose-dependent influence on melanoma cell adhesion that was much more pronounced in the case of α3β1 integrin binding. Molecular modeling indicated that galactosylation occurred on the periphery of α2β1 integrin interaction with α1(IV)382-393 but right in the middle of α3β1 integrin interaction with α1(IV)531-543. The possibility of extracellular deglycosylation of type IV collagen was investigated, but no β-galactosidase-like activity capable of collagen modification was found. Thus, glycosylation of collagen can modulate integrin binding, and levels of glycosylation could be altered by reduction in expression of glycosylation enzymes but most likely not by extracellular deglycosylation activity.
Collapse
Affiliation(s)
- Maciej J Stawikowski
- From the Torrey Pines Institute for Molecular Studies, Port St. Lucie, Florida 34987 and
| | - Beatrix Aukszi
- the Nova Southeastern University, Fort Lauderdale, Florida 33314
| | - Roma Stawikowska
- From the Torrey Pines Institute for Molecular Studies, Port St. Lucie, Florida 34987 and
| | - Mare Cudic
- From the Torrey Pines Institute for Molecular Studies, Port St. Lucie, Florida 34987 and
| | - Gregg B Fields
- From the Torrey Pines Institute for Molecular Studies, Port St. Lucie, Florida 34987 and
| |
Collapse
|
8
|
Kroon HM, Huismans AM, Kam PC, Thompson JF. Isolated limb infusion with melphalan and actinomycin D for melanoma: A systematic review. J Surg Oncol 2014; 109:348-51. [DOI: 10.1002/jso.23553] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 12/12/2013] [Indexed: 12/13/2022]
Affiliation(s)
| | | | - Peter C.A. Kam
- Sydney Medical School; The University of Sydney; Sydney NSW Australia
- Discipline of Anaesthetics; The University of Sydney; Sydney NSW Australia
- Department of Anaesthetics; Royal Prince Alfred Hospital; Camperdown NSW Australia
| | - John F. Thompson
- Melanoma Institute Australia; Sydney NSW Australia
- Discipline of Surgery; The University of Sydney; Sydney NSW Australia
- Department of Melanoma and Surgical Oncology; Royal Prince Alfred Hospital; Camperdown NSW Australia
| |
Collapse
|
9
|
Möller MG, Salwa S, Soden DM, O’Sullivan GC. Electrochemotherapy as an adjunct or alternative to other treatments for unresectable or in-transit melanoma. Expert Rev Anticancer Ther 2014; 9:1611-30. [DOI: 10.1586/era.09.129] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
10
|
Speijers MJ, Francken AB, Hoekstra-Weebers JEHM, Bastiaannet E, Kruijff S, Hoekstra HJ. Optimal follow-up for melanoma. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.10.38] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
11
|
Hoekstra HJ, Veerman K, van Ginkel RJ. Isolated limb perfusion for in-transit melanoma metastases: Melphalan or TNF-melphalan perfusion? J Surg Oncol 2014; 109:338-47. [DOI: 10.1002/jso.23552] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 12/05/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Harald J. Hoekstra
- Department of Surgical Oncology; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - Kelly Veerman
- Department of Surgical Oncology; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - Robert J. van Ginkel
- Department of Surgical Oncology; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| |
Collapse
|
12
|
|
13
|
Wojtkowiak JW, Verduzco D, Schramm KJ, Gillies RJ. Drug resistance and cellular adaptation to tumor acidic pH microenvironment. Mol Pharm 2011; 8:2032-8. [PMID: 21981633 DOI: 10.1021/mp200292c] [Citation(s) in RCA: 364] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite advances in developing novel therapeutic strategies, a major factor underlying cancer related death remains resistance to therapy. In addition to biochemical resistance, mediated by xenobiotic transporters or binding site mutations, resistance can be physiological, emerging as a consequence of the tumor's physical microenvironment. This review focuses on extracellular acidosis, an end result of high glycolytic flux and poor vascular perfusion. Low extracellular pH, pHe, forms a physiological drug barrier described by an "ion trapping" phenomenon. We describe how the acid-outside plasmalemmal pH gradient negatively impacts drug efficacy of weak base chemotherapies but is better suited for weakly acidic therapeutics. We will also explore the physiologic changes tumor cells undergo in response to extracellular acidosis which contribute to drug resistance including reduced apoptotic potential, genetic alterations, and elevated activity of a multidrug transporter, p-glycoprotein, pGP. Since low pHe is a hallmark of solid tumors, therapeutic strategies designed to overcome or exploit this condition can be developed.
Collapse
Affiliation(s)
- Jonathan W Wojtkowiak
- Department of Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, United States
| | | | | | | |
Collapse
|
14
|
Catalano O, Voit C, Sandomenico F, Mandato Y, Petrillo M, Franco R, Botti G, Caracò C, Mozzillo N, D'Errico AG. Previously reported sonographic appearances of regional melanoma metastases are not likely due to necrosis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:1041-1049. [PMID: 21795479 DOI: 10.7863/jum.2011.30.8.1041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Sonography has proven to be a reliable tool in early detection of lymph node and in-transit cutaneous-subcutaneous metastases. Those metastases normally appear as hypoechoic or even anechoic lesions on sonography. It has been assumed that this appearance is due to necrosis of the lesions, but so far, that assumption has never been proven. The purpose of this retrospective study was to evaluate whether the hypoechoic appearance of melanoma metastasis is really due to tumor necrosis. METHODS From a radiographic database, we retrieved 212 melanoma cases imaged with sonography over a 2-year period for disease staging or follow-up. We selected 37 positive cases with 84 nodal and extranodal (satellite and in-transit) metastatic lesions and reviewed the sonograms and pathologic slides (slides available for 40 of 84 lesions). We retrospectively assessed the vascularization pattern (color Doppler images available for 78 of 84 lesions), categorizing it as poor, intermediate, or consistent. We also looked for necrosis on the histopathologic material, categorizing it into scores of 0, 1, 2, and 3 for absence of necrosis, less than 20% necrosis, 20% to 40% necrosis, and greater than 40% necrosis, respectively. RESULTS Despite their gray scale appearance, most melanoma lesions were vascularized on color Doppler imaging and showed limited necrosis at histopathologic analysis. Consistent vascularization on Doppler imaging, excluding substantial necrosis, was found in 44 of 78 lesions (56.4%). Poor vascularization on Doppler imaging, suggesting necrosis, was present in only 14% of the lesions. Substantial necrosis (scores of 2 and 3) was found pathologically in only 10% of the lesions. CONCLUSIONS Necrosis seems to be an uncommon event in melanoma metastasis and is probably not the basis for its low-level echo pattern on sonography. The hypoechoic appearance is very typical of melanoma metastasis and is likely due to massive melanomatous infiltration (with the poor echo reflectivity of melanin). However, confirmation in larger pathologically proven series is required.
Collapse
Affiliation(s)
- Orlando Catalano
- Department of Radiology, National Cancer Institute, Fondazione G. Pascale, via Semmola, 80131 Naples, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Kroon HM. Treatment of locally advanced melanoma by isolated limb infusion with cytotoxic drugs. J Skin Cancer 2011; 2011:106573. [PMID: 21822495 PMCID: PMC3142703 DOI: 10.1155/2011/106573] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 06/03/2011] [Indexed: 11/17/2022] Open
Abstract
Since its introduction in the late 1950s, isolated limb perfusion (ILP) has been the preferred treatment option for locally advanced melanoma and sarcoma confined to a limb. This treatment results in high response rates with a satisfying duration of response in both tumor types. A drawback of ILP, however, is the invasive and complex character of the procedure. Isolated limb infusion (ILI) has been designed in the early 1990s as a minimally invasive alternative to ILP. Results of this simple procedure, reported by various centers around the world, show comparable response rates for melanoma and sarcoma when compared to ILP. Due to its minimally invasive character, ILI may replace ILP in the future as the preferred treatment for these locally advanced limb tumors.
Collapse
Affiliation(s)
- Hidde M. Kroon
- Melanoma Institute Australia, Royal Prince Alfred Hospital, University of Sydney, Missenden Road Camperdown, NSW 2050, Australia
- Rijnland Hospital, Simon Smithweg 1, 2353 GA Leiderdorp, The Netherlands
| |
Collapse
|
16
|
Preclinical Efficacy of Vascular Disrupting Agents in Non–Small-Cell Lung Cancer. Clin Lung Cancer 2011; 12:81-6. [DOI: 10.1016/j.cllc.2011.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 06/22/2010] [Accepted: 06/22/2010] [Indexed: 11/21/2022]
|
17
|
Khan MK, Powell S, Cox N, Robson A, Murrant N. Cervical in-transit metastasis from a truncal basal cell carcinoma. BMJ Case Rep 2010; 2010:2010/jul16_2/bcr0920092281. [PMID: 22767568 DOI: 10.1136/bcr.09.2009.2281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The authors describe a rare case in which a cervical metastatic basal cell carcinoma (BCC) occurred from a small, non-ulcerated primary lesion on the trunk of a female patient. The metastasis had the same immunohistochemical staining pattern as several biopsies from the primary site. It was immediately adjacent to the left neck regional nodes and we view this as an in-transit metastasis. There is often debate about the validity of BCC metastases to lymph nodes but an in-transit lesion strengthens the argument that this does rarely occur.
Collapse
|
18
|
Frigo L, Luppi JSS, Favero GM, Maria DA, Penna SC, Bjordal JM, Bensadoun RJ, Lopes-Martins RAB. The effect of low-level laser irradiation (In-Ga-Al-AsP - 660 nm) on melanoma in vitro and in vivo. BMC Cancer 2009; 9:404. [PMID: 19930543 PMCID: PMC2784797 DOI: 10.1186/1471-2407-9-404] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Accepted: 11/20/2009] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND It has been speculated that the biostimulatory effect of Low Level Laser Therapy could cause undesirable enhancement of tumor growth in neoplastic diseases. The aim of the present study is to analyze the behavior of melanoma cells (B16F10) in vitro and the in vivo development of melanoma in mice after laser irradiation. METHODS We performed a controlled in vitro study on B16F10 melanoma cells to investigate cell viability and cell cycle changes by the Tripan Blue, MTT and cell quest histogram tests at 24, 48 and 72 h post irradiation. The in vivo mouse model (male Balb C, n = 21) of melanoma was used to analyze tumor volume and histological characteristics. Laser irradiation was performed three times (once a day for three consecutive days) with a 660 nm 50 mW CW laser, beam spot size 2 mm(2), irradiance 2.5 W/cm(2) and irradiation times of 60s (dose 150 J/cm(2)) and 420s (dose 1050 J/cm(2)) respectively. RESULTS There were no statistically significant differences between the in vitro groups, except for an increase in the hypodiploid melanoma cells (8.48 +/- 1.40% and 4.26 +/- 0.60%) at 72 h post-irradiation. This cancer-protective effect was not reproduced in the in vivo experiment where outcome measures for the 150 J/cm(2) dose group were not significantly different from controls. For the 1050 J/cm(2) dose group, there were significant increases in tumor volume, blood vessels and cell abnormalities compared to the other groups. CONCLUSION LLLT Irradiation should be avoided over melanomas as the combination of high irradiance (2.5 W/cm(2)) and high dose (1050 J/cm(2)) significantly increases melanoma tumor growth in vivo.
Collapse
Affiliation(s)
- Lúcio Frigo
- Biological Sciences and Health Center, Cruzeiro do Sul University. Av. Dr. Ussiel Cirilo, 225 São Miguel Paulista, 08060-070 São Paulo, SP - Brasil
| | - Juliana SS Luppi
- Biological Sciences and Health Center, Cruzeiro do Sul University. Av. Dr. Ussiel Cirilo, 225 São Miguel Paulista, 08060-070 São Paulo, SP - Brasil
| | - Giovani M Favero
- State University of Ponta Grossa, General Biology Department, Av. Gal. Carlos Cavalvcanti, 4748 Ponta Grossa 84030-900, PR - Brasil
| | - Durnavei A Maria
- Laboratory of Biochemistry and Biophysics, Butantan Institute, Av. Dr. Vital Brasil, 1500 São Paulo 05599-000, SP - Brasil
| | - Sócrates C Penna
- Laboratory of Pharmacology and Phototherapy of Inflammation, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo - São Paulo 05508-900 SP - Brasil
| | - Jan M Bjordal
- Institute for Physiotherapy, Bergen University College, Moellendalsvn. 6, 5009 Bergen, Norway
- Section of Physiotherapy Science, Institute of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway
| | - Rene J Bensadoun
- Service d'Oncologie Radiothérapique, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 - Poitiers Cedex, France
| | - Rodrigo AB Lopes-Martins
- Laboratory of Pharmacology and Phototherapy of Inflammation, Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo - São Paulo 05508-900 SP - Brasil
| |
Collapse
|