術後再発悪性黒色腫に対する温熱化学療法

Background & Purpose：Many reports have been published concerning the efficacy of thermoradiotherapy for the treatment of recurrent malignant melanoma. To determine the effectiveness and toxic reactions to regional hyperthermia and systemic CDDP plus INF-β with or without irradiation for the treatment of recurrent and metastatic malignant melanoma. Case reports：Two patients with recurrent and metastatic malignant melanoma who were previously and definitively treated were included in this study. The first case had two bulky lesions in the right forearm and in the axillaly fossa. The lesion in the right forearm was treated with thermoradiotherapy (radiotherapy：9 fractions, 3 days a week in twenty days, hyperthermia 5 fractions in days 4, 8, 11 and 19). The lesion in the axillaly fossa was heated simultaneously without irradiation. Chemotherapy consisted of CDDP 30mg/m2 and plus INF-β days 1 and 8 and 15. Numbness of the right hand was mitigated a day after the first hyperthermia. Swelling of the both lesions almost disappeared two weeks thereafter. Abnormal deposits of both lesions almost disappeared 2 month after treatment in PET examinations. The second case had also bulky tumors in the liver and in the lung. The lesion in the liver was mainly heated twice a week for 4 weeks combined with chemotherapy (CDDP 30mg/m2 and plus INF-β) once a week. The CT image a month after treatment showed minor response of the tumor in the liver and progression of the tumor in the lung. Thereafter the lesions in the liver and the lung (partially) has been heated once a week hyperthermia and treated with chemotherapy twice a month. Conclusion：The efficacy of thermoradiotherapy for the treatment of recurrent and metastatic malignant melanoma is well known. We experienced the usefulness of thermochemotherapy composed of CDDP plus INF-β. Thermochemotherapy should be considered as one of the treatments of recurrent and metastatic malignant melanoma.