Treatment of metastatic melanoma by 24-hour DTIC infusions and hemibody irradiation

Abstract

Forty-three patients with widely metastatic melanoma were studied. Visceral metastases were present in 79% of the patient group, including five patients with brain metastases. No patients were excluded because of “early death,” etc., from analysis. All 43 patients received 24-hour DTIC infusions. Dosages for individual patients ranged from 350 mg/M² to 2.5 g/M², a maximum of 6 courses being given. A total of 155 courses was administered. Hemibody irradiation (HBI) was delivered after 1 or 3 courses of DTIC to the area of maximum disease in 23 patients. Fourteen of the 43 patients responded to DTIC chemotherapy (with one complete response), a response rate of 33%. Seven of the chemotherapy responders also responded in other sites to subsequent HBI, a response rate of 30% (7/23). No patient responded to HBI and not to DTIC. Median survival was 4 months (range, 1–15), and nine patients are still alive at 3 to 15 months. Toxicity was generally mild, although there was one possible treatment-related death. Further exploration of DTIC infusion chemotherapy and HBI would be of interest.