[Treatment of metastatic malignant melanoma localized to an extremity].
BACKGROUND
At the Norwegian Radium Hospital, most patients who were treated for metastases (localized to an extremity) from malignant melanoma in the period 1977-99 underwent intra-arterial chemotherapy combined with radiotherapy. We have evaluated the effects of this treatment, which has now been replaced by isolated limb perfusion (with melphalan and tumor necrosis factor).


METHODS
Medical records were reviewed for patients with metastatic malignant melanoma (localized to an extremity) who had been treated at the Norwegian Radium Hospital with intra-arterial chemotherapy (5-[3,3 dimethyl-1-triazeno]-imidazole-4-carboxamide [DTIC]) in the period 1977-99.


RESULTS
36 patients had received such treatment; in 30 of these the induction treatment was combined with radiation of the tumour area.. 24 patients were in complete remission after treatment (12 of these had all the metastases surgically removed before treatment). Nine patients had a partial remission while three patients had progressive disease. Median observation time was 49 months. 15 of 31 patients had an observation time of more than five years, and seven of these patients were alive after ten years. Three patients with metastasis localized to the lower extremity died of other causes. In one case the intra-arterial catheterisation caused serious aortic damage.


CONCLUSIONS
It is possible to achieve long-term remission in patients with metastatic malignant melanoma localized to an extremity after intra-arterial chemotherapy combined with radiotherapy.
Jacobsen
Kari Dolven
KD
Kreftklinikken, Oslo universitetssykehus, Radiumhospitalet, Montebello, 0310 Oslo, Norway. kari.dolven.jacobsen@radiumhospitalet.no
Tausjø
Johan
J
Hager
Bjarne
B
Gundersen
Stein
S
D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D035002:Lower Extremity / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D008875:Middle Aged; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012042:Registries; D012074:Remission Induction; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D015996:Survival Rate; D016896:Treatment Outcome; D034941:Upper Extremity / Q000473:pathology
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine