Intraarterial infusion chemotherapy in regionally advanced malignant melanoma

The therapeutic effectiveness of intraarterial cisplatin (CDDP) and dacarbazine (DTIC) infusion was examined in 30 evaluable patients with regionally advanced melanoma that was refractory to standard treatments. Objective responses were achieved in 11 patients (37%), including three complete (10%) and eight partial (27%) tumor regressions. Successful debulking surgery was performed in seven of the eleven patients with response. Six remained free of regional disease after a median time of 25 months, and four are also free of distant metastases at 24+, 25+, 41+, and 54+ months. Nineteen of thirty patients with no significant tumor response underwent alternative treatments. Debulking surgery was performed in nine, but with little palliative gain, since seven relapsed at a median time of 5 months. Our results suggest that a combined therapeutic approach--preoperative chemotherapy followed by surgery in responding tumors--represents an effective treatment for patients with regionally advanced melanoma.