Hansson J A, Simert G, Vang J
Acta Chir Scand. 1977;143(1):33-9.
16 patients with cutaneous or subcutaneous melanoma recurrence on an extremity were treated with regional perfusion with Melphalan. 18 perfusions were performed on 15 patients with stage II disease, that is with tumor growth restricted to an extremity including possible regional node metastases. All patients except two had new recurrences within the observation time. However, many of the patients had been treated surgically for recurrences once or several times previously. By comparing the length of the recurrence-free period following surgery alone with that following surgery plus perfusion in the same patients it was shown that perfusion treatment gave a significant extension of the recurrence-free time. Four perfusions were performed on patients in stage III, that is those with distant metastases. These perfusions gave a moderate or good temporary palliation as regards to tumor growths on the extremity. The traditional treatment for melanoma recurrences on an extremity has been surgical excision or less often amputation. An analysis of the literature shows that perfusion, usually combined with excision, seems to give definitely better results than surgical excision alone. There is evidence to suggest that perfusion treatment is even superior to amputation as regards survival; if so an immunological mechanism might be responsible for this effect.
16例肢体皮肤或皮下黑色素瘤复发患者接受了美法仑区域灌注治疗。对15例II期疾病患者进行了18次灌注，即肿瘤生长局限于肢体，包括可能的区域淋巴结转移。除2例患者外，所有患者在观察期内均出现新的复发。然而，许多患者此前曾因复发接受过一次或多次手术治疗。通过比较同一患者单纯手术后无复发期的长度与手术加灌注后的无复发期长度，结果表明灌注治疗显著延长了无复发时间。对III期患者，即有远处转移的患者进行了4次灌注。这些灌注在缓解肢体肿瘤生长方面起到了中度或良好的暂时缓解作用。肢体黑色素瘤复发的传统治疗方法是手术切除，较少情况下是截肢。文献分析表明，灌注（通常与切除相结合）似乎比单纯手术切除效果肯定更好。有证据表明，就生存率而言，灌注治疗甚至优于截肢；如果是这样，免疫机制可能是造成这种效果的原因。
