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在一项倾向评分匹配的单中心研究中,患有转移性黑色素瘤的患者在接受隔离肢体灌注或瘤内注射PV-10后具有可比的生存结果。

Patients with in-transit melanoma metastases have comparable survival outcomes following isolated limb infusion or intralesional PV-10-A propensity score matched, single center study.

作者信息

Read Tavis, Fayers Warren, Thomas Janine, Wagels Michael, Barbour Andrew, Mark Smithers B

机构信息

Queensland Melanoma Project, Princess Alexandra Hospital, Queensland Health, Brisbane, Queensland, Australia.

Faculty of Medicine, The University of Queensland, Southern Clinical School, Princess Alexandra Hospital, Brisbane, Australia.

出版信息

J Surg Oncol. 2019 May;119(6):717-727. doi: 10.1002/jso.25373. Epub 2019 Jan 15.

Abstract

BACKGROUND AND OBJECTIVE

Isolated limb infusion (ILI) and intralesional PV-10 are well described locoregional therapies for in-transit melanoma. The objective of this study was to assess the effect of these treatments on survival outcomes within a cohort matched for key characteristics.

METHODS

Patients were treated using ILI or intralesional PV-10 at a single institution and the data prospectively recorded. Propensity score matching was performed using key covariates within a logistic regression model. The primary outcome was the melanoma-specific survival.

RESULTS

Seventy-two patients nonrandomized were successfully matched. Both treatments produced similar best overall responses. The median melanoma-specific survival (MSS) was 74.4 months from ILI and 36.4 months from PV-10 treatments (P = 0.164). Within the ILI subgroup, the 12-, 24-, 36- and 60-month MSS rates were 85.3%, 75.3%, 60.1%, and 60.1%, respectively. From the time of PV-10 the corresponding 12-, 24-, 36-, and 60-month MSS rates were 82.6%, 70.0%, 53.9%, and 35.9%. On multivariate analysis, there was a significant difference in survival comparing completely with noncomplete responders ( P = 0.031).

CONCLUSIONS

These findings demonstrate that ILI and PV-10 treatments for in-transit disease produce comparable long-term survival. Both therapies have reproducible response rates and predominantly localized and tolerable side-effects.

摘要

背景与目的

孤立肢体灌注(ILI)和病灶内注射PV - 10是已被充分描述的治疗移行性黑素瘤的局部区域疗法。本研究的目的是评估这些治疗对一组关键特征匹配的患者生存结局的影响。

方法

在单一机构对患者采用ILI或病灶内注射PV - 10进行治疗,并对数据进行前瞻性记录。在逻辑回归模型中使用关键协变量进行倾向评分匹配。主要结局是黑素瘤特异性生存。

结果

72例未随机分组的患者成功匹配。两种治疗产生的最佳总体反应相似。ILI治疗的黑素瘤特异性生存中位数(MSS)为74.4个月,PV - 10治疗为36.4个月(P = 0.164)。在ILI亚组中,12个月、24个月、36个月和60个月的MSS率分别为85.3%、75.3%、60.1%和60.1%。从PV - 10治疗时起,相应的12个月、24个月、36个月和60个月的MSS率分别为82.6%、70.0%、53.9%和35.9%。多因素分析显示,完全缓解者与未完全缓解者的生存存在显著差异(P = 0.031)。

结论

这些发现表明,ILI和PV - 10治疗移行性疾病可产生相当的长期生存。两种疗法都有可重复的缓解率,且主要是局部的、可耐受的副作用。

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