Hafström L, Jönsson P E
Acta Chir Scand. 1980;146(5):313-8.
Twenty-one patients with recurrent malignant melanoma on the extremities were treated by regional hyperthermic perfusion with melphalan (Alkeran). Four patients had a second perfusion. The recurrence site was on the foot in one patient, on the lower part of the leg in 13 patients, below the mid-thigh in 6 patients and on the elbow in one patient. The temperature of the extremities was registered continuously during the perfusion. Perfusion was performed under hyperthermic conditions with a temperature of 40-41.0 degrees C i.m. The perfusion time was 2 hours. Alkeran was given in a dose of 0.9 mg/kg bodyweight for lower extremity perfusion and 0.45 mg/kg for upper extremity perfusion. Complete tumour regression or more than 50% tumour regression was registered in 8 out of the 10 patients with manifest tumour. As the first sign of recurrence after perfusion, 4 patients had local recurrence and 10 had systemic recurrence. Altogether one-third of the patients had local recurrences and half of the patients systemic recurrences. Local recurrences occurred after a median time of 8 months and systemic recurrences after a median time of 7 months. Nine patients are still alive after an observation time of 5.5 months to 44 months. Three patients are without any signs of recurrent disease.
21例四肢复发性恶性黑色素瘤患者接受了美法仑（左旋苯丙氨酸氮芥）区域热灌注治疗。4例患者接受了第二次灌注。复发部位：足部1例，小腿下部13例，大腿中部以下6例，肘部1例。灌注过程中持续记录四肢温度。在40 - 41.0摄氏度的热疗条件下进行肌肉注射灌注，灌注时间为2小时。下肢灌注时美法仑剂量为0.9mg/kg体重，上肢灌注时为0.45mg/kg。10例有明显肿瘤的患者中，8例出现完全肿瘤消退或肿瘤消退超过50%。作为灌注后复发的首个迹象，4例患者出现局部复发，10例出现全身复发。总共有三分之一的患者出现局部复发，一半的患者出现全身复发。局部复发的中位时间为8个月，全身复发的中位时间为7个月。经过5.5个月至44个月的观察期后，9例患者仍然存活。3例患者无任何复发疾病迹象。
