Does increased experience with isolated limb infusion for advanced limb XXXX influence outcome? A comparison of two treatment periods at a single institution.

@entity1 @entity137 @entity5 @entity4316 @entity320
BACKGROUND: Isolated limb infusion (ILI) with cytotoxic drugs has been used since 1992 to treat advanced @entity320 confined to a limb. Over this time the technique has undergone progressive modification. In this study we evaluated our experience with ILI by analyzing outcome and @entity137 from an "early" and a "late" treatment period. METHODS: We compared the results from our institution for 94 @entity1 treated by ILI in the early period (1992-1999) with the results for 91 @entity1 treated in the late period (2000-2007). All @entity1 had advanced limb @entity320 and received a combination of melphalan and @entity4316 . RESULTS: The @entity1 characteristics of the early and late groups were similar, but there was greater @entity5 load in the late group, who had a significantly greater number of lesions (median 4 vs. 5; p = 0.02) and @entity5 (p = 0.03). Drug circulation times were longer in the late group: 22 vs. 31 min (p < 0.0001). In the late group, higher initial and final limb temperatures were achieved. Overall response rates were 85% in both groups. The late treatment group showed a trend towards less @entity137 (p = 0.06). CONCLUSIONS: Response rates and survival following ILI for advanced @entity320 in our late treatment period were similar to those of our early treatment period, despite the significantly greater @entity5 load of the @entity1 treated in the late period. This could be attributed to increased experience and protocol modifications, which allowed longer drug exposure times and higher limb temperatures to be achieved without increased @entity137 .
