多発性転移巣に対しシスプラチンの経肝動脈性投与を行った肛門管部原発悪性黒色腫

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This paper presents a case of a 48-year-old female patient with multiple liver metastasis from a rectal malignant melanoma. On first admission her performance status (PS) was 4 and serum lactate dehydrogenase (LDH) was 5205U/l. She received intrahepatic arterial administration of cisplatin (CDDP) 100mg in bolus, and the primary rectal melanoma was surgically resected. After the therapy, LDH decreased to 3193U/l. A totally implantable catheter connected to a subcutaneous access chamber was placed into the hepatic artery. Using this cahteter, we gave her CDDP total 7 times as follows: CDDP 100mg for five times and then 70mg for two times, every 3 or 4 weeks. After the 4th admission her PS became 1 and serum LDH decreased to 403U/l, but mild thrombocytepenia, anemia and general fatigue appeared. After that, serum LDH increased again to 609U/l. Then she received dacarbazine 200mg daily for five tims using the catheter, however, LDH level incresed gradually and her general condision worsened. Chemoembolization to the feeding arteries along with intrahepatic arterial infusion of CDDP were performed, but she died six months later from her first admission.Although the duration of response was limited, the intra hepatic arterial administration of CDDP improved the quality of life of this patient. This therapy may be an alternative for the control of liver metastasis of malignant melanoma.
日本皮膚悪性腫瘍学会の論文