Intracarotid cisplatin-based chemotherapy in patients with malignant melanoma and central nervous system (CNS) metastases.
Twenty-three patients with malignant melanoma metastatic to the central nervous system (CNS) were treated with intracarotid cisplatin-based chemotherapy. Twenty-two had failed prior cranial radiation therapy (one patient refused radiation therapy) and had progressive brain metastases documented by computerized tomography (CT). Intracarotid cisplatin 40-75 mg/m2 was administered alone (seven patients) with 1,3-bis(2-Chloroethyl)-1-nitrosourea (BCNU) (13 patients) or bleomycin (three patients). Courses were repeated monthly with CT scan. Seven patients (30%) had objective improvement in CT scans and three patients (13%) had stabilization of disease. The median time to tumor progression for responding patients was 20 weeks (range 8-34 weeks) while stable disease ranged from 9-12 weeks. In three patients the extracranial disease progressed while the brain metastases responded. Neurological and retinal toxicity were potential complications of therapy. Intracarotid cisplatin-based chemotherapy may be useful for palliation in selected patients with malignant melanoma and CNS metastases.
Feun
L G
LG
Department of Oncology, University of Miami, Florida 33136.
Lee
Y Y
YY
Plager
C
C
Papadopoulos
N
N
Savaraj
N
N
Charnsangavej
C
C
Benjamin
R S
RS
Wallace
S
S
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary; D002330:Carmustine / Q000008:administration & dosage; D002343:Carotid Artery, Internal; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D010166:Palliative Care; D012074:Remission Induction
D001761:Bleomycin; D002945:Cisplatin; D002330:Carmustine