Decian F, Mondini G, Demarchi R, Muzio G, Sementa A, Bocchio M M, Spirito C, Simoni G, Civalleri D
Department of Clinical Surgery, University of Genoa, Italy.
Anticancer Res. 1996 Jul-Aug;16(4A):2017-24.
Hyperthermic Antiblastic Perfusion (HAP) is a widely used method for the treatment of recurrent limb melanoma. In terms of tumor response, locoregional control and survival HAP has led to better results than those achieved with any other treatment. The aim of this report is to analyze our own experience with HAP in locally advanced limb melanoma. Thirty-two patients were submitted to HAP. HAP lasted 60 minutes, with maximal local temperature of 40.5-42 degrees C using melphalan 10 mg/L limb volume as antiblastic agent. Twenty patients had in-transit metastases and 12 local recurrence. Regional nodes were involved in 12 patients. Systemic leakage monitored with 125I or 99Tc ranged between 5-30% (mean 14%). No operative mortality nor major complications occurred. Local toxicity scored Wieberdink grade I in 8 patients, grade II in 17, grade III in 6 and grade IV in 1 case. Response rate (UICC) in the 16 patients treated with unexcised lesions was 94% (56% complete responses). With a median follow-up of 29 months (2-126) 14 patients relapsed after a median time of 10 months, and 17 patients are currently disease free, 3 of these are being reexcised and 3 re-perfused. Actuarial 5 years survival was 64%, with 39% 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.
热疗抗增殖灌注（HAP）是一种广泛应用于复发性肢体黑色素瘤治疗的方法。在肿瘤反应、局部区域控制和生存率方面，HAP比其他任何治疗方法都取得了更好的效果。本报告的目的是分析我们自己在局部晚期肢体黑色素瘤HAP治疗方面的经验。32例患者接受了HAP治疗。HAP持续60分钟，使用美法仑10mg/L肢体体积作为抗增殖剂，局部最高温度为40.5 - 42摄氏度。20例患者有途中转移，12例为局部复发。12例患者区域淋巴结受累。用125I或99Tc监测的全身渗漏率在5% - 30%之间（平均14%）。未发生手术死亡或严重并发症。局部毒性根据Wieberdink分级，I级8例，II级17例，III级6例，IV级1例。16例未切除病变患者的反应率（UICC）为94%（56%为完全缓解）。中位随访29个月（2 - 126个月），14例患者在中位时间10个月后复发，17例患者目前无疾病，其中3例正在再次切除，3例再次灌注。5年精算生存率为64%，39%至首次复发时无疾病。我们的结果与文献一致，表明HAP是一种安全的方法，有很高的临床反应证据。
