Isolated limb hot perfusion improves the efficacy of malignant melanoma

a 49-year-oldfemalepatient, right foot malignant melanoma surgery in May after the right lower limb multiple metastasis, transferred to a number ofhospitalstreatment results are not good, recently came to BeijingCancerHospitalThe hospital's director of renal cancer melanoma, Guo Jun, completed the first isolated limb hot perfusion treatment (ILI) for herAfter surgery patients only appear mild local skin erythema, swelling and myoenzyme elevated, two weeks after the related symptoms improved, patients can basically get out of bed activity, after treatment did not appear a new metastasis, local part of the skin lesions have been significantly reduced, the patient was discharged from the hospital smoothlyMalignant melanoma is a kind of highly malignanttumorderived from melanocytes, which is resonating, misdiagnosis rate is high, malignant degree is high, prone to recurrence and metastasis, and the prognosis is very poorOften occurred in the skin and adjacent skin mucous membranes, eye pigment membranes and meninges veins, can also be seen in the digestive tract mucous membranes and hands and feetThe treatment of malignant melanoma is mainly surgery, and for patients who cannot operate, chemotherapy and biological treatment can be taken, but with low efficiencyAlthough early detection of early treatment, the patient's five-year survival rate after surgery can reach 60% to 80%, but the survival rate of advanced patients is less than 5%, while melanoma is prone to recurrence and metastasis, so the prognosis is very poorMalignant melanomas that occur at the end of the limb account for about 50% of all melanomas, and it occurs as high as 53% of regional metastasis and local recurrencesTraditional treatments such as chemotherapy, radiotherapy and biological chemotherapy are inefficient, and the usual clinical lysator is amputation, which has a great negative impact on the quality of life of patients Therefore, there is an urgent need for an effective method to treat malignant melanoma at the end of the limb In 1992, the melanoma center in Sydney, Australia began to use ILI to treat end-of-limb malignant melanoma, the development has become a treatment of limb malignant melanoma, especially stage III/IV recurrence and regional metastasis of a powerful weapon Beijing Cancer Hospital after sending people out for further study, the first in the country to introduce this advanced technology According to Guo Jun, isolation limb hot perfusion treatment is a new technology that is the blood circulation and body circulation of the affected limb, and the use of local hot injection chemotherapy drugs in the limb This technique greatly increases the concentration of chemotherapy drugs (15 to 25 times higher than conventional systemic chemotherapy doses) and increases tumor killing effect exponentially while heating (39 to 40 degrees) chemotherapy drugs and limbs Severe systemic chemotherapy side effects are avoided because of the isolation of the blood circulation of the affected limbs from the body circulation The technology is not complicated - please intervene in the tube after the area limb heating, isolation of blood flow, chemotherapy drugs are pumped into the artery, through the simple in vitro heating cycle machine intravenous end absorption, arterial end injection, manual circulation 30 minutes after flushing is basically completed Guo Jun said that the technology is efficient, simple operation and equipment, small side response, has become the internationally recognized treatment of limb end-of-body melanoma the main means The technology has been used abroad for more than 10 years, its effectiveness has been internationally recognized, and has been written in the NCCN guidelines and melanoma textbooks The Sydney Melanoma Centre treated 305 patients with relapsed or progressive limb melanoma with a total efficiency of 85 per cent, CR 44 per cent, stable 12 per cent and progress 4 per cent He introduced the advantages of this technique compared with some of the original treatment methods of malignant melanoma: compared with conventional chemotherapy, high efficiency; Its disadvantage is only to increase the local toxic side reaction Isolated limb hot perfusion chemotherapy has thousands of clinical application experience in the world, its clinical efficiency (lesions disappeared and significantly reduced) about 80%, while conventional systemic chemotherapy efficiency is only 15% to 20% At present, isolated limb hot infusion chemotherapy is an internationally recognized standard for limb melanoma (partial recurrence and transfer) treatment method, high efficiency and good safety Guo Jun said that the original limb malignant melanoma patients in the occurrence of regional metastasis and local recurrence after the amputation, and the use of this method after treatment does not need amputation, retain the limb, the patient's quality of life naturally greatly improved Although isolated limb hot infusion chemotherapy is a local treatment, it can prolong the survival of patients and improve the quality of life of patients by reducing tumor reduction Because ILI can be applied to the treatment of nearly 1/3 malignant melanoma patients in China, and the vast majority of patients benefit, and the toxic reaction is relatively small, operability is strong, so it has a great value of clinical application (Zhu Guowang)