Department of General Surgery, University Medical Centre Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
Int J Hyperthermia. 2010 Feb;26(1):16-20. doi: 10.3109/02656730903236086.
The aim is to analyse a modified standardised HILP procedure regarding the response rates, local recurrences and complication rates.
152 patients (101 females, 51 males) with an average age of 62 years and locoregionally metastasised malignant melanoma underwent HILP using melphalan and dactinomycin between 1992 and 2007. Using M.D. Anderson's classification at the time of the perfusion 51 patients presented in stage IIIA, 43 patients in stage IIIAB and 58 patients in stage IV. If indicated, lymph node dissection was performed simultaneously just before perfusion of the extremity.
Complete remission was observed in 91 (62.7%) of 145 patients, partial remission in 26 (17.9%) patients. 28 (19.3%) patients showed no response. The overall response rate was 80.7% (117 of 145 patients). Severe complications (Wieberdink IV/V) were seen in eight cases. The average recurrence-free survival was 17 months. The median survival was 39 months; the five-year overall survival rate was 38%. The overall survival rate was significantly influenced by the stage of the disease.
HILP is an efficient therapy for multiple or recurrent in-transit metastases of malignant melanoma of the lower extremities. The efficiency increased by improving the technique of the perfusion. Long-term survival can be observed in patients without regional lymph node metastases or distant metastases.
分析改良标准 HILP 手术的缓解率、局部复发率和并发症发生率。
1992 年至 2007 年间，152 例局部转移的恶性黑色素瘤患者（101 例女性，51 例男性）接受了 HILP 治疗，使用的药物为美法仑和放线菌素 D。在进行灌注时，根据 M.D.安德森分类，51 例患者处于 IIIA 期，43 例患者处于 IIIAB 期，58 例患者处于 IV 期。如果需要，在进行肢体灌注前同时进行淋巴结清扫术。
145 例患者中，91 例（62.7%）达到完全缓解，26 例（17.9%）达到部分缓解。28 例（19.3%）患者无反应。总的缓解率为 80.7%（117/145 例）。8 例出现严重并发症（Wieberdink IV/V）。无复发生存期平均为 17 个月。中位生存期为 39 个月；5 年总生存率为 38%。疾病分期显著影响总生存率。
HILP 是治疗下肢恶性黑色素瘤多发或复发性移行性转移的有效方法。通过改进灌注技术，可提高疗效。无区域淋巴结转移或远处转移的患者可观察到长期生存。
