Fotemustine chemoembolization of hepatic metastases from uveal melanoma: a retrospective single-center analysis

AJR Am J Roentgenol. 2012 Dec;199(6):1387-92. doi: 10.2214/AJR.11.7748.

Abstract

Objective: The purpose of the current study was to retrospectively evaluate response and survival in patients with hepatic metastasis from uveal melanoma treated by palliative transarterial chemoembolization (TACE) with fotemustine.

Materials and methods: During the study period, 21 patients with hepatic metastases from uveal melanoma were treated by TACE. A series of TACE interventions (mean number per patient, 3.29 interventions; range, 1-6 interventions) was performed on each patient with an emulsion of fotemustine dissolved in 10 mL of saline mixed with 10 mL of an oily contrast agent. Tumor response based on the Response Evaluation Criteria in Solid Tumors was evaluated using contrast-enhanced CT scans obtained 6-10 weeks after embolization.

Results: CT showed partial regression after TACE in three patients (14%). Six patients (29%) presented with stable disease but no significant change in tumor size after TACE, and 12 patients (57%) presented with progressive disease after TACE treatment. The overall response rate was 43%. The mean survival after diagnosis of hepatic metastasis was 28.7 months.

Conclusion: TACE of hepatic metastasis from uveal melanoma with fotemustine is well tolerated, and the survival rates in this study (mean, 28.7 months) are among the longest reported.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / therapeutic use*
  • Chemoembolization, Therapeutic / methods*
  • Contrast Media / administration & dosage
  • Ethiodized Oil / therapeutic use
  • Female
  • Humans
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy*
  • Male
  • Melanoma / diagnostic imaging
  • Melanoma / secondary*
  • Melanoma / therapy*
  • Middle Aged
  • Nitrosourea Compounds / therapeutic use*
  • Organophosphorus Compounds / therapeutic use*
  • Proportional Hazards Models
  • Retrospective Studies
  • Survival Rate
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Uveal Neoplasms / pathology*

Substances

  • Antineoplastic Agents
  • Contrast Media
  • Nitrosourea Compounds
  • Organophosphorus Compounds
  • Ethiodized Oil
  • fotemustine