Department of Radiology, University of North Carolina School of Medicine, 101 Manning Drive, CB 7510, Chapel Hill, NC, USA.
Department of Pharmacy, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Cardiovasc Intervent Radiol. 2021 May;44(5):801-806. doi: 10.1007/s00270-020-02748-3. Epub 2021 Jan 14.
To evaluate the safety and feasibility of ultrasound-guided intralesional injection of Talimogene laherparepvec (Imlygic, T-VEC) in patients with advanced non-palpable melanoma.
Fourteen consecutive patients (mean age, 67.9 years ± 13.0; range, 40-88; 12 males) with unresectable, locally advanced melanoma underwent ultrasound-guided intralesional injections of T-VEC (July 2016-March 2020) into subcutaneous lesions. Tumor response to the injection was evaluated at the last follow-up. Technical success and complication rates were recorded.
The T-VEC injection was technically successful in all patients with all lesions successfully punctured (100%). The mean number of lesions, injection cycles, and injection volumes were 4.1 ± 2.6 (1-9), 6.5 ± 3.0 (3-12), and 2.6 mL ± 1.4 (1-4 mL), respectively. During the follow-up period (mean, 21.0 months ± 13.4; range 1-43.6 months), complete remission, partial remission, persistent disease, and disease progression were observed in 6 (42.9%), 3 (21.4%), 1 (7.1%), and 4 (28.6%) patients, respectively. Post-treatment symptoms observed in 9 patients (64.3%), including fever (n = 2), fatigue (n = 1), headache (n = 1), pain (n = 1), mouth sores (n = 1), and flu-like symptoms (n = 3). No injection-related complications occurred in all procedures.
Intralesional injection of T-VEC for non-palpable metastases under ultrasound guidance is safe and feasible in patients with advanced melanoma.
评估超声引导下瘤内注射替莫唑胺拉滨（T-VEC，Imlygic）治疗晚期不可触及性黑色素瘤患者的安全性和可行性。
2016 年 7 月至 2020 年 3 月，14 例不可切除的局部晚期黑色素瘤患者（平均年龄 67.9±13.0 岁，范围 40-88 岁，男性 12 例）接受了 T-VEC 瘤内注射（超声引导）治疗，将 T-VEC 注射到皮下病变部位。在最后一次随访时评估肿瘤对注射的反应。记录技术成功率和并发症发生率。
所有患者的 T-VEC 注射均成功，所有病变均成功穿刺（100%）。平均病灶数、注射周期和注射量分别为 4.1±2.6（1-9）、6.5±3.0（3-12）和 2.6±1.4（1-4mL）。在随访期间（平均 21.0±13.4 个月，范围 1-43.6 个月），6 例（42.9%）患者完全缓解，3 例（21.4%）患者部分缓解，1 例（7.1%）患者疾病持续存在，4 例（28.6%）患者疾病进展。9 例（64.3%）患者出现治疗后症状，包括发热（2 例）、疲劳（1 例）、头痛（1 例）、疼痛（1 例）、口腔炎（1 例）和流感样症状（3 例）。所有手术均未发生与注射相关的并发症。
在超声引导下，瘤内注射 T-VEC 治疗晚期黑色素瘤患者的不可触及性转移是安全可行的。
