Practical dermatology
Study and Treatment of Locally Advanced Melanoma
Melanoma Localmente Avanzado. Estudio y Tratamiento
D. Moreno-Ramíreza,
, L. de la Cruzb, L. Ferrándiza, F.M. Camachoa
Autor para correspondencia
dmoreno@e-derma.org
Correspondence: Departamento de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen Macarena, Avda. Dr. Fedriani s/n, 41009 Sevilla, Spain.
Correspondence: Departamento de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen Macarena, Avda. Dr. Fedriani s/n, 41009 Sevilla, Spain.
Leído
6286
Vecesse ha leído el artículo
3033
Total PDF
3253
Total HTML
Compartir estadísticas
array:23 [ "pii" => "S1578219009701726" "issn" => "15782190" "doi" => "10.1016/S1578-2190(09)70172-6" "estado" => "S300" "fechaPublicacion" => "2009-11-01" "aid" => "70172" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "copyrightAnyo" => "2009" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2009;100:767-79" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2751 "formatos" => array:3 [ "EPUB" => 39 "HTML" => 1463 "PDF" => 1249 ] ] "itemSiguiente" => array:18 [ "pii" => "S1578219009701738" "issn" => "15782190" "doi" => "10.1016/S1578-2190(09)70173-8" "estado" => "S300" "fechaPublicacion" => "2009-11-01" "aid" => "70173" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2009;100:780-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2420 "formatos" => array:3 [ "EPUB" => 34 "HTML" => 1471 "PDF" => 915 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original articles</span>" "titulo" => "Full Thickness Skin Grafts Obtained From the Skin Overlying Sentinel Nodes" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "780" "paginaFinal" => "784" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Injertos de Piel Total Obtenidos de la Zona del Ganglio Centinela" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Clemente-Ruiz de Almirón, S. Serrano-Ortega" "autores" => array:2 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Clemente-Ruiz de Almirón" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Serrano-Ortega" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219009701738?idApp=UINPBA000044" "url" => "/15782190/0000010000000009/v1_201304241507/S1578219009701738/v1_201304241507/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1578219009701714" "issn" => "15782190" "doi" => "10.1016/S1578-2190(09)70171-4" "estado" => "S300" "fechaPublicacion" => "2009-11-01" "aid" => "70171" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2009;100:759-66" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7103 "formatos" => array:3 [ "EPUB" => 44 "HTML" => 1725 "PDF" => 5334 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Controversies in dermatology</span>" "titulo" => "Problems in Defining Melanoma Regression and Prognostic Implication" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "759" "paginaFinal" => "766" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Regresión en el Melanoma: Problemas en su Definición e Implicación Pronóstica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Requena, R. Botella-Estrada, V. Traves, E. Nagore, S. Almenar, C. Guillén" "autores" => array:6 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Requena" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Botella-Estrada" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Traves" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Nagore" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Almenar" ] 5 => array:2 [ "nombre" => "C." "apellidos" => "Guillén" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219009701714?idApp=UINPBA000044" "url" => "/15782190/0000010000000009/v1_201304241507/S1578219009701714/v1_201304241507/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Practical dermatology</span>" "titulo" => "Study and Treatment of Locally Advanced Melanoma" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "767" "paginaFinal" => "779" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "D. Moreno-Ramírez, L. de la Cruz, L. Ferrándiz, F.M. Camacho" "autores" => array:4 [ 0 => array:4 [ "nombre" => "D." "apellidos" => "Moreno-Ramírez" "email" => array:1 [ 0 => "dmoreno@e-derma.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "de la Cruz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Ferrándiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "F.M." "apellidos" => "Camacho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Oncología Médica, Hospital Universitario Virgen Macarena, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Departamento de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen Macarena, Avda. Dr. Fedriani s/n, 41009 Sevilla, Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Melanoma Localmente Avanzado. Estudio y Tratamiento" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2009-04-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec84603" "palabras" => array:5 [ 0 => "melanoma" 1 => "locally advanced melanoma" 2 => "in-transit metastasis" 3 => "satellitosis" 4 => "isolated limb perfusion" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84604" "palabras" => array:5 [ 0 => "melanoma" 1 => "melanoma localmente avanzado" 2 => "metástasis en tránsito" 3 => "satelitosis" 4 => "perfusión del miembro aislado" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Locally advanced melanoma is characterized clinically by the appearance of in-transit or satellite metastases, and is considered stage IIIB or IIIC according to the 2002 classification of the American Joint Committee on Cancer. Despite the absence of distant metastases, the management of locally advanced melanoma is complicated and the disease is associated with a reduction in overall survival. The initial step in the approach to the patient with locally advanced melanoma involves restaging in order to exclude the presence of distant metastases. Positron emission tomography-computed tomography is currently accepted as the most accurate restaging technique. Surgical excision of the metastases continues to be the treatment of choice for locally advanced melanoma. In the case of unresectable metastases, hyperthermic isolated limb perfusion with melphalan with or without tumor necrosis factor has achieved complete responses in up to 60% of patients treated, with very rare severe locoregional and systemic toxic effects. Radiation therapy, chemotherapy, and biochemotherapy are options that, even though they have not been tested in patients with only in-transit metastases, may have a role in unresectable, locally advanced melanoma without distant metastases. In any case, therapeutic options for locally advanced melanoma should be individualized, and should take into consideration the availability of each of these techniques as well as the experience of the health care team.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">El melanoma localmente avanzado representa un estadio clínico caracterizado principalmente por la presencia de metástasis en tránsito o satelitosis, estadios IIIB o IIIC de la clasificación <span class="elsevierStyleItalic">American Joint Committee on Cancer</span> de 2002, y que en ausencia de metástasis a distancia, representa un acortamiento en la supervivencia del paciente y un escenario clínico de manejo complejo.</p><p class="elsevierStyleSimplePara elsevierViewall">La aproximación al paciente en este estadio debe iniciarse con una reestadificación que permita descartar la presencia de metástasis a distancia, para lo que se acepta como técnica con mayor validez la tomografía por emisión de positrones-tomografía computarizada. La exéresis quirúrgica de la/s metástasis continúa siendo considerada el tratamiento de primera elección en la enfermedad localmente avanzada.</p><p class="elsevierStyleSimplePara elsevierViewall">En caso de metástasis irresecables la perfusión hipertérmica del miembro aislado con melfalán con o sin factor de necrosis tumoral, proporciona porcentajes de respuesta completa del 60%, con toxicidad sistémica y locorregional grave muy poco frecuente. La radioterapia, quimioterapia y bioquimioterapia son alternativas terapéuticas que, aunque no han sido estudiadas exclusivamente en el paciente con metástasis en tránsito, pueden tener un papel en la enfermedad localmente avanzada irresecable sin metástasis a distancia.</p><p class="elsevierStyleSimplePara elsevierViewall">En cualquier caso, las opciones terapéuticas en el melanoma localmente avanzado clínico deben ser individualizadas para cada paciente y teniendo en cuenta la disponibilidad de cada una de las técnicas y la experiencia del equipo de profesionales con cada una de ellas.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:48 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiología del melanoma en España" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Saenz" 1 => "J. Conejo-Mir" 2 => "A. Cayuela" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2005" "volumen" => "96" "paginaInicial" => "411" "paginaFinal" => "418" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476268" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Final version of the American Joint Committee on Cancer Staging System for Cutaneous Melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.M. Balch" 1 => "A.C. Buzaid" 2 => "S.J. Soong" 3 => "M.B. Atkins" 4 => "N. Cascinelli" 5 => "D.G. Coit" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/jco.2001.19.16.3635" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2001" "volumen" => "19" "paginaInicial" => "3635" "paginaFinal" => "3648" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11504745" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of in-transit metastases from cutaneous malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.J. Hayes" 1 => "M.A. Clark" 2 => "M. Harries" 3 => "J.M. Thomas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/bjs.4610" "Revista" => array:6 [ "tituloSerie" => "Br J Surg" "fecha" => "2004" "volumen" => "91" "paginaInicial" => "673" "paginaFinal" => "682" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15164434" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors and natural histor y of in-transit melanoma after sentinel lymphadenectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.M. Pawlik" 1 => "M.I. Ross" 2 => "M.M. Johnson" 3 => "C.W. Schacherer" 4 => "D.M. McClain" 5 => "P.F. Mansfield" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/ASO.2005.05.025" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2005" "volumen" => "12" "paginaInicial" => "587" "paginaFinal" => "596" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16021533" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognosis and surgical management of patients with palpable inguinal lymph node metastases from melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.M. Hughes" 1 => "R.P. A’Hern" 2 => "J.M. Thomas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2168.2000.01439.x" "Revista" => array:6 [ "tituloSerie" => "Br J Surg" "fecha" => "2000" "volumen" => "87" "paginaInicial" => "892" "paginaFinal" => "901" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10931025" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A prospective analysis of positron emission tomography and conventional imaging for detection of stage IV metastatic melanoma in patients undergoing metastasectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.E. Finkelstein" 1 => "J.A. Carrasquillo" 2 => "J.M. Hoffman" 3 => "B. Galen" 4 => "P. Choyke" 5 => "D.E. White" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/ASO.2004.01.023" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2004" "volumen" => "11" "paginaInicial" => "731" "paginaFinal" => "738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15249335" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Malignant melanoma: staging with whole body positron emission tomography and 2-(F-18)fluoro-2deoxy-Dglucose" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.C. Steinert" 1 => "R.A. Huch Boni" 2 => "A. Buck" 3 => "R. Boni" 4 => "T. Berthold" 5 => "B. Marincek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiology.195.3.7753998" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "1995" "volumen" => "195" "paginaInicial" => "705" "paginaFinal" => "709" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7753998" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The role of fluorine-18 deoxyglucose positron emission tomography in the management of patients with metastatic melanoma: impact on surgical decision making" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.A. Gulec" 1 => "M.B. Faries" 2 => "C.C. Lee" 3 => "D. Kirgan" 4 => "C. Glass" 5 => "D.L. Morton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.rlu.0000099805.36471.aa" "Revista" => array:6 [ "tituloSerie" => "Clin Nucl Med" "fecha" => "2003" "volumen" => "28" "paginaInicial" => "961" "paginaFinal" => "965" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14663316" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PET-TAC: Indicaciones, revisión sistemática y metaanálisis. Agencia de Evaluación de Tecnologías Sanitarias (AETS)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Rodríguez Garrido" 1 => "C. Asensio del Barrio" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo" "fecha" => "2004" "editorial" => "Instituto de Salud Carlos III" "editorialLocalizacion" => "Madrid" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hyperthermic isolated limb perfusion with low-dose tumor necrosis factor and melphalan for bulky in-transit melanoma metastases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.R. Rossi" 1 => "M. Foletto" 2 => "S. Mocellin" 3 => "P. Pilati" 4 => "M. Lise" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2004" "volumen" => "11" "paginaInicial" => "173" "paginaFinal" => "177" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14761920" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of hyperthermic isolated limb perfusion for extremity-confined recurrent melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Brobeil" 1 => "C. Berman" 2 => "C.W. Cruse" 3 => "R. De Conti" 4 => "A. Cantor" 5 => "G.H. Lyman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "1998" "volumen" => "5" "paginaInicial" => "376" "paginaFinal" => "383" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9641461" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Major amputation for advanced malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.P. Jaques" 1 => "D.G. Coit" 2 => "M.F. Brennan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Surg Gynaecol Obstet" "fecha" => "1989" "volumen" => "169" "paginaInicial" => "1" "paginaFinal" => "6" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Major amputation for intractable extremity melanoma after failure of isolated limb perfusion" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.R. Kapma" 1 => "B.C. Vrouenraets" 2 => "O.E. Nieweg" 3 => "A.N. Van Geel" 4 => "E.M. Noorda" 5 => "A.M. Eggermont" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejso.2004.10.003" "Revista" => array:6 [ "tituloSerie" => "Eur J Surg Oncol" "fecha" => "2005" "volumen" => "31" "paginaInicial" => "95" "paginaFinal" => "99" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15642433" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of carbon dioxide laser to manage cutaneous metastases from malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Hill" 1 => "J.M. Thomas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Br J Surg" "fecha" => "1996" "volumen" => "83" "paginaInicial" => "509" "paginaFinal" => "512" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8665245" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1552526010000774" "estado" => "S300" "issn" => "15525260" ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Carbon dioxide laser for cutaneous melanoma metastases: indications and limitations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Strobbe" 1 => "O. Nieweg" 2 => "B. Kroon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Surg Oncol" "fecha" => "1997" "volumen" => "23" "paginaInicial" => "435" "paginaFinal" => "438" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9393574" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Experiences with Isolation-Perfusion Technics in the Treatment of Cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "O. Creech" 1 => "E.T. Krementz" 2 => "R.F. Ryan" 3 => "K. Reemtsa" 4 => "J.N. Winblad" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Surg" "fecha" => "1959" "volumen" => "149" "paginaInicial" => "627" "paginaFinal" => "639" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13637680" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized multicenter trial of hyperthermic isolated limb perfusion with melphalan alone compared with melphalan plus tumor necrosis factor: American College of Surgeons Oncology Group Trial Z0020" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.R. Cornett" 1 => "L.M. McCall" 2 => "R.P. Petersen" 3 => "M.I. Ross" 4 => "H.A. Briele" 5 => "R.D. Noyes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J ClinOncol" "fecha" => "2006" "volumen" => "24" "paginaInicial" => "4196" "paginaFinal" => "4201" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated limb perfusion: what is the evidence for its use?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.M. Noorda" 1 => "B.C. Vrouenraets" 2 => "O.E. Nieweg" 3 => "F. Van Coevorden" 4 => "B.B. Kroon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/ASO.2004.12.042" "Revista" => array:7 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2004" "volumen" => "11" "paginaInicial" => "837" "paginaFinal" => "845" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15313738" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1474442209702996" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of extremity recurrences after complete responses to isolated limb perfusion in patients with melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.L. Feldman" 1 => "H.R. Alexander" 2 => "D.L. Bartlett" 3 => "D.L. Fraker" 4 => "S.K. Libitti" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "1999" "volumen" => "6" "paginaInicial" => "562" "paginaFinal" => "567" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10493624" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Repeat isolated limb perfusion with TNFa and melphalan for recurrent limb melanoma after failure of previous perfusion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E.M. Noorda" 1 => "B.C. Vrouenraets" 2 => "O.E. Nieweg" 3 => "A.N. van Geel" 4 => "A.MM. Eggermont" 5 => "B.BR. Kroon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejso.2005.10.009" "Revista" => array:6 [ "tituloSerie" => "Eur J Surg Oncol" "fecha" => "2006" "volumen" => "32" "paginaInicial" => "318" "paginaFinal" => "324" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16412605" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Moreno-Ramírez D, de la Cruz L, Ferrándiz L,Villegas-Portero R. Perfusión del miembro aislado en el tratamiento del melanoma y sarcoma de partes blandas. Informe técnico de evaluación. Agencia de evaluación de Tecnologías Sanitarias. In press, 2008." ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento tópico de las metástasis cutáneas de melanoma con imiquimod" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Sigüenza" 1 => "A. Pizarro" 2 => "M. Mayor" 3 => "C. Vidaurrázaga" 4 => "L. Miralles" 5 => "M. González-Beato" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2005" "volumen" => "96" "paginaInicial" => "111" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476347" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical imiquimod treatment of a cutaneous melanoma metastasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Steinmann" 1 => "J.O. Funk" 2 => "G. Schuler" 3 => "P. von den Driesch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2000" "volumen" => "43" "paginaInicial" => "556" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10954676" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical imiquimod eradicates skin metastases of malignant melanoma but fails to prevent rapid lymphogenous metastatic spread" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Ugurel" 1 => "A. Wagner" 2 => "C. Pföhler" 3 => "W. Tilgen" 4 => "U. Reinhold" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2002" "volumen" => "147" "paginaInicial" => "621" "paginaFinal" => "624" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12207622" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imiquimod, a topical immune response modifier, in the treatment of cutaneous metastases of malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.B. Bong" 1 => "B. Bonnekoh" 2 => "I. Franke" 3 => "M.P. Schön" 4 => "J. Ulrich" 5 => "H. Gollnick" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "63904" "Revista" => array:6 [ "tituloSerie" => "Dermatology" "fecha" => "2002" "volumen" => "205" "paginaInicial" => "135" "paginaFinal" => "138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12218228" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical imiquimod in the treatment of metastatic melanoma to skin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I.H. Wolf" 1 => "J. Smolle" 2 => "B. Binder" 3 => "L. Cerroni" 4 => "E. Richtig" 5 => "H. Kerl" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2003" "volumen" => "139" "paginaInicial" => "273" "paginaFinal" => "276" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12622616" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of cutaneous locoregional recurrences of melanoma: a new therapeutic perspective with imiquimod" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Vereecken" 1 => "A. Mathieu" 2 => "M. Laporte" 3 => "M. Petein" 4 => "T. Velu" 5 => "A. Awada" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "68901" "Revista" => array:7 [ "tituloSerie" => "Dermatology" "fecha" => "2003" "volumen" => "206" "paginaInicial" => "279" "paginaFinal" => "280" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12673091" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1552526010000142" "estado" => "S300" "issn" => "15525260" ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "In vivo and in situ modulation of the expression of genes involved in metastasis and angiogenesis in a patient treated with topical imiquimod for melanoma skin metastases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Hesling" 1 => "M. D’Incan" 2 => "S. Mansard" 3 => "F. Franck" 4 => "A. Corbin-Duval" 5 => "C. Chèvenet" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.0007-0963.2004.05898.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2004" "volumen" => "150" "paginaInicial" => "761" "paginaFinal" => "767" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15099376" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imiquimod para el tratamiento de las metástasis cutáneas de melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Nagore" 1 => "O. Sanmartín" 2 => "R. Botella-Estrada" 3 => "C. Guillén" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2005" "volumen" => "96" "paginaInicial" => "549" "paginaFinal" => "550" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476296" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Phase I/II study of topical imiquimod and intralesional interleukin-2 in the treatment of accessible metastases in malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.S. Green" 1 => "M.D. Bodman-Smith" 2 => "A.G. Dalgleish" 3 => "M.D. Fischer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2006.07664.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2007" "volumen" => "156" "paginaInicial" => "337" "paginaFinal" => "345" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17223875" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Phase II trial of intralesional therapy with interleukin-2 in soft-tissue melanoma metastases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Radny" 1 => "U.M. Carola" 2 => "J. Bauer" 3 => "T. Paul" 4 => "C. Schlegel" 5 => "T.K. Eigentler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.bjc.6601320" "Revista" => array:6 [ "tituloSerie" => "Br J Cancer" "fecha" => "2003" "volumen" => "89" "paginaInicial" => "1620" "paginaFinal" => "1626" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14583759" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perilesional injection of R-GM-CSF in patients with cutaneous melanoma metastases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Hoeller" 1 => "B. Jansen" 2 => "E. Heere-Ress" 3 => "T. Pustelnik" 4 => "U. Mossbacher" 5 => "H. Schlagbauer-Wadl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.0022-202x.2001.01427.x" "Revista" => array:6 [ "tituloSerie" => "J Invest Dermatol" "fecha" => "2001" "volumen" => "117" "paginaInicial" => "371" "paginaFinal" => "374" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11511318" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib33" "etiqueta" => "33." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized controlled study of electrochemotherapy in the local treatment of skin metastases of melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Gaudy" 1 => "M.A. Richard" 2 => "G. Folchetti" 3 => "J.J. Bonerandi" 4 => "J.J. Grob" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Cutan Med Surg" "fecha" => "2006" "volumen" => "10" "paginaInicial" => "115" "paginaFinal" => "121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17241586" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib34" "etiqueta" => "34." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of metastatic melanoma using electroporation therapy with bleomycin (electrochemotherapy)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.M. Byrne" 1 => "J.F. Thompson" 2 => "H. Johnston" 3 => "P. Hersey" 4 => "M.J. Quinn" 5 => "T. Michael Hughes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Melanoma Res" "fecha" => "2005" "volumen" => "15" "paginaInicial" => "45" "paginaFinal" => "51" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15714120" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib35" "etiqueta" => "35." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dispelling the myths surrounding radiotherapy for treatment of cutaneous melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Stevens" 1 => "M.J. McKay" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1470-2045(06)70758-6" "Revista" => array:6 [ "tituloSerie" => "Lancet Oncol" "fecha" => "2006" "volumen" => "7" "paginaInicial" => "575" "paginaFinal" => "583" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16814209" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib36" "etiqueta" => "36." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The spectrum of in vitro radiosensitivity in four human melanoma cell lines is not accounted for by differential induction or rejoining of DNA double strand breaks" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.J. McKay" 1 => "R.F. Kefford" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Radiat Oncol Biol Phys" "fecha" => "1995" "volumen" => "31" "paginaInicial" => "345" "paginaFinal" => "352" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7836088" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib37" "etiqueta" => "37." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomised trial of hyperthermia as adjuvant to radiotherapy for recurrent or metastatic malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Overgaard" 1 => "D. González González" 2 => "M.C. Hulshof" 3 => "G. Arcangeli" 4 => "O. Dahl" 5 => "O. Mella" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1995" "volumen" => "345" "paginaInicial" => "540" "paginaFinal" => "543" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7776772" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib38" "etiqueta" => "38." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fraction size in external beam radiation therapy in the treatment of melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.T. Sause" 1 => "J.S. Cooper" 2 => "S. Rush" 3 => "C.T. Ago" 4 => "D. Cosmatos" 5 => "C.T. Coughlin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Radiat OncolBiol Phys" "fecha" => "1991" "volumen" => "20" "paginaInicial" => "429" "paginaFinal" => "432" ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib39" "etiqueta" => "39." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Locally advanced melanoma: results of postoperative hypofractionated radiation therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Stevens" 1 => "J.F. Thompson" 2 => "I. Firth" 3 => "C.J. O’Brien" 4 => "W.H. McCarthy" 5 => "M.J. Quinn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2000" "volumen" => "88" "paginaInicial" => "88" "paginaFinal" => "94" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10618610" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib40" "etiqueta" => "40." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systemic chemotherapy for the treatment of metastatic melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y. Li" 1 => "E.F. McClay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Semin Oncol" "fecha" => "2002" "volumen" => "29" "paginaInicial" => "413" "paginaFinal" => "426" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12407507" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib41" "etiqueta" => "41." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Re-evaluating the role of dacarbazine in metastatic melanoma: what have we learned in 30 years?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.M.M. Eggermont" 1 => "J.M. Kirkwood" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejca.2004.04.030" "Revista" => array:6 [ "tituloSerie" => "Eur J Cancer" "fecha" => "2004" "volumen" => "40" "paginaInicial" => "1825" "paginaFinal" => "1836" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15288283" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib42" "etiqueta" => "42." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chemotherapy for metastatic melanoma. Time for a change?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H.J. Gogas" 1 => "J.M. Kirkwood" 2 => "V.K. Sondak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.22427" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2007" "volumen" => "109" "paginaInicial" => "455" "paginaFinal" => "464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17200963" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib43" "etiqueta" => "43." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized phase III study of temozolomide versus dacarbazine in the treatment of patients with advanced metastatic malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.R. Middleton" 1 => "J.J. Grob" 2 => "N. Aaronson" 3 => "G. Fierlbeck" 4 => "W. Tilgen" 5 => "S. Seiter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/jco.2000.18.1.158" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2000" "volumen" => "18" "paginaInicial" => "158" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10623706" "web" => "Medline" ] ] ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib44" "etiqueta" => "44." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Phase III multicenter randomized trial of Dartmouth regimen versus dacarbazine in patients with metastatic melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.B. Chapman" 1 => "L. Einhorn" 2 => "M.L. Meyers" 3 => "S. Saxman" 4 => "A.N. Destro" 5 => "K.S. Panageas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/jco.1999.17.9.2745" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "1999" "volumen" => "17" "paginaInicial" => "2745" "paginaFinal" => "2761" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10561349" "web" => "Medline" ] ] ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib45" "etiqueta" => "45." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Combination chemotherapy with or without s.c. IL-2 and IFN-α: results of a prospectively randomized trial of the Cooperative Advanced Malignant Melanoma Chemoimmunotherapy Group" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Atzpodien" 1 => "K. Neuber" 2 => "D. Kamanabrou" 3 => "M. Fluck" 4 => "E.B. Bröcker" 5 => "C. Neumann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.bjc.6600043" "Revista" => array:6 [ "tituloSerie" => "Br J Cancer" "fecha" => "2002" "volumen" => "86" "paginaInicial" => "179" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11870502" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib46" "etiqueta" => "46." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multiinstitutional Phase II trial of intensive combination chemoimmunotherapy for metastatic melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.B. Atkins" 1 => "K.R. O’ Boyle" 2 => "J.A. Sosma" 3 => "G.R. Weiss" 4 => "K.A. Margolin" 5 => "M.L. Ernest" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/jco.1994.12.8.1553" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "1994" "volumen" => "12" "paginaInicial" => "1553" "paginaFinal" => "1560" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8040667" "web" => "Medline" ] ] ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib47" "etiqueta" => "47." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development of a biochemotherapy regimen with concurrent administration of cisplatin, vinblastine, dacarbazine, interferon alfa, and interleukin-2 for patients with metastatic melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.S. Legha" 1 => "S. Ring" 2 => "O. Eton" 3 => "A. Bedikian" 4 => "A.C. Buzaid" 5 => "C. Plager" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/jco.1998.16.5.1752" "Revista" => array:7 [ "tituloSerie" => "J Clin Oncol" "fecha" => "1998" "volumen" => "16" "paginaInicial" => "1752" "paginaFinal" => "1759" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9586888" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022510X9700141X" "estado" => "S300" "issn" => "0022510X" ] ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib48" "etiqueta" => "48." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A Phase II study of dacarbazine and cisplatin in combination with outpatient administered interleukin-2 in metastatic malignant melanoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.E. Flaherty" 1 => "W. Robinson" 2 => "B.G. Redman" 3 => "R. González" 4 => "S. Martino" 5 => "M. Kraut" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "1993" "volumen" => "71" "paginaInicial" => "3520" "paginaFinal" => "3525" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8490900" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010000000009/v1_201304241507/S1578219009701726/v1_201304241507/en/main.assets" "Apartado" => array:4 [ "identificador" => "6151" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Practical Dermatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010000000009/v1_201304241507/S1578219009701726/v1_201304241507/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219009701726?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 5 | 8 | 13 |
| 2024 Octubre | 60 | 45 | 105 |
| 2024 Septiembre | 56 | 24 | 80 |
| 2024 Agosto | 86 | 62 | 148 |
| 2024 Julio | 55 | 25 | 80 |
| 2024 Junio | 67 | 35 | 102 |
| 2024 Mayo | 49 | 27 | 76 |
| 2024 Abril | 51 | 26 | 77 |
| 2024 Marzo | 68 | 42 | 110 |
| 2024 Febrero | 45 | 35 | 80 |
| 2024 Enero | 47 | 44 | 91 |
| 2023 Diciembre | 45 | 36 | 81 |
| 2023 Noviembre | 53 | 27 | 80 |
| 2023 Octubre | 39 | 15 | 54 |
| 2023 Septiembre | 45 | 45 | 90 |
| 2023 Agosto | 34 | 26 | 60 |
| 2023 Julio | 28 | 39 | 67 |
| 2023 Junio | 47 | 32 | 79 |
| 2023 Mayo | 37 | 22 | 59 |
| 2023 Abril | 31 | 29 | 60 |
| 2023 Marzo | 22 | 22 | 44 |
| 2023 Febrero | 18 | 20 | 38 |
| 2023 Enero | 24 | 30 | 54 |
| 2022 Diciembre | 30 | 36 | 66 |
| 2022 Noviembre | 14 | 26 | 40 |
| 2022 Octubre | 15 | 20 | 35 |
| 2022 Septiembre | 20 | 49 | 69 |
| 2022 Agosto | 13 | 37 | 50 |
| 2022 Julio | 14 | 32 | 46 |
| 2022 Junio | 14 | 31 | 45 |
| 2022 Mayo | 27 | 39 | 66 |
| 2022 Abril | 37 | 53 | 90 |
| 2022 Marzo | 29 | 50 | 79 |
| 2022 Febrero | 20 | 34 | 54 |
| 2022 Enero | 32 | 39 | 71 |
| 2021 Diciembre | 15 | 45 | 60 |
| 2021 Noviembre | 28 | 51 | 79 |
| 2021 Octubre | 30 | 57 | 87 |
| 2021 Septiembre | 23 | 41 | 64 |
| 2021 Agosto | 28 | 29 | 57 |
| 2021 Julio | 12 | 33 | 45 |
| 2021 Junio | 12 | 23 | 35 |
| 2021 Mayo | 14 | 23 | 37 |
| 2021 Abril | 27 | 65 | 92 |
| 2021 Marzo | 41 | 29 | 70 |
| 2021 Febrero | 52 | 41 | 93 |
| 2021 Enero | 31 | 14 | 45 |
| 2020 Diciembre | 27 | 14 | 41 |
| 2020 Noviembre | 17 | 12 | 29 |
| 2020 Octubre | 25 | 17 | 42 |
| 2020 Septiembre | 20 | 11 | 31 |
| 2020 Agosto | 24 | 19 | 43 |
| 2020 Julio | 10 | 14 | 24 |
| 2020 Junio | 20 | 27 | 47 |
| 2020 Mayo | 19 | 20 | 39 |
| 2020 Abril | 18 | 14 | 32 |
| 2020 Marzo | 20 | 21 | 41 |
| 2020 Febrero | 0 | 3 | 3 |
| 2020 Enero | 0 | 11 | 11 |
| 2019 Diciembre | 0 | 6 | 6 |
| 2019 Noviembre | 0 | 3 | 3 |
| 2019 Septiembre | 0 | 6 | 6 |
| 2019 Agosto | 0 | 3 | 3 |
| 2019 Julio | 0 | 4 | 4 |
| 2019 Junio | 0 | 19 | 19 |
| 2019 Mayo | 0 | 60 | 60 |
| 2019 Abril | 0 | 31 | 31 |
| 2019 Marzo | 0 | 7 | 7 |
| 2019 Febrero | 0 | 10 | 10 |
| 2019 Enero | 0 | 5 | 5 |
| 2018 Diciembre | 0 | 5 | 5 |
| 2018 Septiembre | 0 | 6 | 6 |
| 2018 Agosto | 0 | 23 | 23 |
| 2018 Julio | 0 | 5 | 5 |
| 2018 Junio | 0 | 15 | 15 |
| 2018 Mayo | 0 | 15 | 15 |
| 2018 Abril | 0 | 3 | 3 |
| 2018 Marzo | 0 | 9 | 9 |
| 2018 Febrero | 15 | 16 | 31 |
| 2018 Enero | 9 | 17 | 26 |
| 2017 Diciembre | 15 | 12 | 27 |
| 2017 Noviembre | 7 | 17 | 24 |
| 2017 Octubre | 14 | 12 | 26 |
| 2017 Septiembre | 10 | 32 | 42 |
| 2017 Agosto | 11 | 11 | 22 |
| 2017 Julio | 8 | 28 | 36 |
| 2017 Junio | 17 | 26 | 43 |
| 2017 Mayo | 15 | 22 | 37 |
| 2017 Abril | 24 | 36 | 60 |
| 2017 Marzo | 15 | 24 | 39 |
| 2017 Febrero | 11 | 14 | 25 |
| 2017 Enero | 9 | 26 | 35 |
| 2016 Diciembre | 31 | 19 | 50 |
| 2016 Noviembre | 28 | 17 | 45 |
| 2016 Octubre | 22 | 33 | 55 |
| 2016 Septiembre | 33 | 16 | 49 |
| 2016 Agosto | 23 | 17 | 40 |
| 2016 Julio | 31 | 6 | 37 |
| 2016 Junio | 11 | 10 | 21 |
| 2016 Mayo | 12 | 4 | 16 |
| 2016 Abril | 9 | 11 | 20 |
| 2016 Marzo | 3 | 15 | 18 |
| 2016 Febrero | 7 | 1 | 8 |
| 2016 Enero | 4 | 15 | 19 |
| 2015 Diciembre | 6 | 19 | 25 |
| 2015 Noviembre | 16 | 17 | 33 |
| 2015 Octubre | 6 | 19 | 25 |
| 2015 Septiembre | 10 | 14 | 24 |
| 2015 Agosto | 11 | 5 | 16 |
| 2015 Julio | 34 | 5 | 39 |
| 2015 Junio | 35 | 5 | 40 |
| 2015 Mayo | 70 | 7 | 77 |
| 2015 Abril | 36 | 10 | 46 |
| 2015 Marzo | 26 | 14 | 40 |
| 2015 Febrero | 25 | 10 | 35 |
| 2015 Enero | 11 | 10 | 21 |
| 2014 Diciembre | 25 | 5 | 30 |
| 2014 Noviembre | 24 | 5 | 29 |
| 2014 Octubre | 33 | 8 | 41 |
| 2014 Septiembre | 35 | 10 | 45 |
| 2014 Agosto | 52 | 15 | 67 |
| 2014 Julio | 49 | 17 | 66 |
| 2014 Junio | 55 | 9 | 64 |
| 2014 Mayo | 44 | 13 | 57 |
| 2014 Abril | 45 | 9 | 54 |
| 2014 Marzo | 43 | 25 | 68 |
| 2014 Febrero | 36 | 15 | 51 |
| 2014 Enero | 32 | 13 | 45 |
| 2013 Diciembre | 30 | 16 | 46 |
| 2013 Noviembre | 25 | 17 | 42 |
| 2013 Octubre | 28 | 20 | 48 |
| 2013 Septiembre | 27 | 19 | 46 |
| 2013 Agosto | 13 | 29 | 42 |
| 2013 Julio | 30 | 40 | 70 |
| 2013 Junio | 29 | 42 | 71 |
| 2013 Mayo | 22 | 19 | 41 |
| 2013 Abril | 27 | 30 | 57 |
| 2013 Marzo | 33 | 21 | 54 |
| 2013 Febrero | 36 | 9 | 45 |
| 2013 Enero | 10 | 4 | 14 |
Mostrar todo
