RESUMO
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 We have evaluated the effects of this treatment, which has now been replaced by isolated limb perfusion (with melphalan and tumor necrosis factor). MATERIAL AND 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. INTERPRETATION: 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.
