title: Selective regional perfusion of the bilateral external carotid arteries with pegylated liposomal doxorubicin and melphalan to treat metastatic malignant melanoma of the scalp.
abstract: We present the case of a 79-year-old patient with extensive metastatic malignant melanoma (MM) of the scalp. Cutaneous MM of the head and neck often presents a therapeutic challenge. Radical surgical procedures and conventional chemotherapy are often unfeasible and contraindicated because of the difficult anatomy, the extent of the tumour process, and systemic toxicity. In our patient, selective intra-arterial perfusion with pegylated liposomal doxorubicin (PLD) and melphalan was performed after catheterization of both bilateral external carotid arteries with an arterial port system. PLD 4.5 mg/m(2) and melphalan (1.35 mg/m(2), followed by 2.7 mg/m(2) after reaching tolerance) were given as short-term infusions at two-weekly intervals into the right and left external carotid arteries, respectively. After eight applications with tolerable side-effects, no MM cells were detected; however, infiltrates of lymphocytes and melanophages were seen. This case suggests that intra-arterial chemotherapy may be a useful treatment for metastatic melanoma of the scalp.
authors.affiliation: Dermatology and Venerology Clinic, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Göppner
authors.forename: S R
authors.initials: SR
authors.lastname: Quist
authors.forename: I
authors.initials: I
authors.lastname: Franke
authors.forename: J
authors.initials: J
authors.lastname: Ulrich
authors.forename: U
authors.initials: U
authors.lastname: Drecoll
authors.forename: T
authors.initials: T
authors.lastname: Bürger
authors.forename: H P M
authors.initials: HP
authors.lastname: Gollnick
authors.forename: B
authors.initials: B
authors.lastname: Bonnekoh
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002342:Carotid Artery, External; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D006801:Humans; D008545:Melanoma / Q000188:drug therapy / Q000473:pathology / Q000556:secondary*; D008558:Melphalan / Q000008:administration & dosage; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012535:Scalp; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology
chemical_list: C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin; D008558:Melphalan