Farolfi A, Ridolfi L, Guidoboni M, Milandri C, Calzolari F, Scarpi E, Amadori D, Ridolfi R
Department of Oncology, Instituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy.
J Chemother. 2011 Oct;23(5):300-5. doi: 10.1179/joc.2011.23.5.300.
The liver is the primary site of metastases in most uveal melanoma patients. We retrospectively investigated intraarterial chemotherapy (IAC) as treatment for patients with hepatic melanoma metastases.Twenty-three patients (18 with uveal melanoma) received fotemustine (14 patients, 61.9%) or carboplatin (9 patients, 31.1%) via hepatic IAC delivery. The catheter was introduced through percutaneous access to the femoral artery with drugs delivered directly to the hepatic artery, and was removed at the end of each treatment cycle. A total of 3 cycles was planned, repeated every 21 days. However, patients with a clinical response could receive more than 3 cycles, provided that the toxic effects were acceptable.IAC was well tolerated and no catheter-related complications or grade 4 toxicities were reported. Considering only uveal melanoma patients, the overall response rate and disease control rate was 16.7% and 38.9%, respectively. Median time to progression was 6.2 months (95% CI 3.7-10.5) and median overall survival was 21 months (95% CI 8-39).IAC is well tolerated and is a valid choice for patients with a poor prognosis since median survival rates are among the longest reported.
在大多数葡萄膜黑色素瘤患者中，肝脏是转移的主要部位。我们回顾性研究了动脉内化疗（IAC）作为肝黑色素瘤转移患者的治疗方法。23例患者（18例为葡萄膜黑色素瘤）通过肝动脉内化疗接受了福莫司汀（14例，61.9%）或卡铂（9例，31.1%）治疗。通过经皮穿刺股动脉插入导管，将药物直接输送至肝动脉，每个治疗周期结束时取出导管。计划共进行3个周期，每21天重复一次。然而，有临床反应的患者只要毒性作用可接受，就可接受超过3个周期的治疗。IAC耐受性良好，未报告与导管相关的并发症或4级毒性反应。仅考虑葡萄膜黑色素瘤患者，总体缓解率和疾病控制率分别为16.7%和38.9%。中位进展时间为6.2个月（95%CI 3.7-10.5），中位总生存期为21个月（95%CI 8-39）。IAC耐受性良好，对于预后较差的患者是一种有效的选择，因为中位生存率是报告中最长的之一。
