Klaase J M, Kroon B B, van Geel B N, Eggermont A M, Franklin H R, Hart G A
Department of Surgery, The Netherlands Cancer Institute, Amsterdam.
Am J Surg. 1994 Jun;167(6):618-20. doi: 10.1016/0002-9610(94)90111-2.
In order to gain some insight into the cause of acute regional toxicity after isolated perfusion using melphalan, 15 patient-related and perfusion-technique-related factors were tested in a logistic regression model. Acute toxicity was graded according to Wieberdink's grading system. In a group of 425 patients, 362 (85%) encountered no or slight toxicity with a grade I or II reaction, and 63 (15%) patients encountered more severe toxicity with a grade III, IV, or V reaction. Most patients were treated with a standard dose of 10 or 13 mg melphalan per liter of perfused tissue for leg and arm perfusions, respectively. Factors associated with a more severe toxicity reaction proved to be tissue temperatures of 40 degrees C or higher, female gender, a deterioration of the gas values of the venous perfusate during perfusion, and perfusion at a proximal level of isolation. Consideration of these prognostic factors may lead to a further decrease of acute regional toxicity in perfusion.
为了深入了解使用美法仑进行隔离灌注后急性局部毒性的原因，在逻辑回归模型中测试了15个与患者和灌注技术相关的因素。急性毒性根据维伯丁克分级系统进行分级。在一组425例患者中，362例（85%）出现I级或II级反应，无毒性或仅有轻微毒性，63例（15%）患者出现III级、IV级或V级反应，毒性更严重。大多数患者分别接受标准剂量的美法仑治疗，腿部灌注每升灌注组织10毫克，手臂灌注每升灌注组织13毫克。与更严重毒性反应相关的因素包括组织温度达到或高于40摄氏度、女性、灌注期间静脉灌注液气体值恶化以及在近端隔离水平进行灌注。考虑这些预后因素可能会进一步降低灌注时的急性局部毒性。
