De Cian F, Rainero M L, Mondini G, Spirito C, D'Addazio G, Simoni G A, Civalleri D
Istituto di Clinica Chirurgica e Terapi Chirurgica I, Università degli Studi di Genova.
Minerva Chir. 1994 Jul-Aug;49(7-8):681-91.
Twenty-two patients with recurrent melanoma of the limbs, underwent Hyperthermic Antiblastic Perfusion (HAP). HAP lasted 60 min, with maximal local temperature of 40.5-42 degrees C and melphalan 10 mg/L limb volume as antiblastic agent. Fourteen patients had in-transit metastases and 8 local recurrences. Regional nodes were involved in 6 patients. Systemic leakage monitored with 125I or 99Tc ranged between 5 and 30% (mean 19%). No operative mortality nor major complications occurred. Local toxicity scored Wieberdink grade I in 6 patients, grade II in 11 and III in 5. Response rate (UICC) in the 9 patients treated with unexcised lesions was 88% (55% complete responses). After a median follow-up of 27 months (1-92) 9 patients relapsed after a median time of 17 months, and 15 patients are currently disease free, 4 of them being re-excised and one reperfused. Actuarial 5 year survival is 67%, with 45% disease free to the first relapse. Our results are consistent with the literature indicating HAP as a safe procedure with a high evidence of clinical responses.
22例肢体复发性黑色素瘤患者接受了热化疗灌注（HAP）治疗。HAP持续60分钟，局部最高温度为40.5 - 42摄氏度，使用美法仑10mg/L肢体体积作为化疗药物。14例患者有皮下转移，8例为局部复发。6例患者区域淋巴结受累。用125I或99Tc监测的全身渗漏率在5%至30%之间（平均19%）。未发生手术死亡或严重并发症。6例患者局部毒性评分为Wieberdink I级，11例为II级，5例为III级。9例未切除病变患者的缓解率（UICC）为88%（55%为完全缓解）。中位随访27个月（1 - 92个月）后，9例患者在中位时间17个月后复发，15例患者目前无疾病，其中4例再次切除，1例再次灌注。5年精算生存率为67%，45%在首次复发前无疾病。我们的结果与文献一致，表明HAP是一种安全的治疗方法，有很高的临床缓解证据。
