Abstract
Fifty-five evaluable patients with disseminated malignant melanoma were treated with the combination of dacarbazine (DTIC) 400 mg i.v. on days 1 to 3 and lomustine (CCNU) 50 to 80 mg m-2 orally on day 1 with intervals of 6 weeks as the first line chemotherapy. Three (5%) patients had complete and 6 (11%) partial response, and 7 (13%) patients had stable disease at least for 3 months. The patients with an objective response (n = 9) survived longer than the rest of the patients if the length of survival was calculated from the start of chemotherapy (P = 0.0006). However, the responding patients also had longer time interval from the diagnosis to the detection of distant metastases (P = 0.05), and survival time from disease progression following DTIC and CCNU therapy (P = 0.005). These findings suggest that patients with an objective response to DTIC-CCNU therapy have melanoma with a slow progression rate, and prolonged survival in such patients may in part result from the less aggressive biological nature of their tumours.
Highlights
Materials and methods Sixty patients with histologically diagnosed malignant melanoma with distant metastases were treated with DTIC 400 mg i.v. on days 1 to 3 and with CCNU 50-80 mg m-2 p.o. on day 1 with 6 weeks' intervals in the Department of Radiotherapy and Oncology, Turku University Central Hospital, in 1979 to 1987
At writing three patients are alive with disease, and 52 (95%) have died from melanoma
Objective responses were seen more frequently in patients with disease confined to subcutaneous tissue or lymph nodes (4/9, 44%), and in patients with pulmonary metastases only (4/20, 20%) than in patients with metastases elsewhere or with multiple involved sites (1/26, 4%, P = 0.03, Table I)
Summary
Sixty patients with histologically diagnosed malignant melanoma with distant metastases were treated with DTIC 400 mg i.v. on days 1 to 3 and with CCNU 50-80 mg m-2 p.o. on day 1 with 6 weeks' intervals in the Department of Radiotherapy and Oncology, Turku University Central Hospital, in 1979 to 1987. Fifty-five patients were evaluable and five nonevaluable for response (two patients refused to continue therapy after one course, one was lost to follow-up, in one case metastases were removed by surgery, and one patient was treated for pulmonary nodules that later turned out to be probably benign). Thirty were male and 25 female, the mean age was 52 years, range, from 21 years to 72 years. The Karnofsky's status ranged from 50 to 100, mean 83. Dissemination of melanoma was confirmed by histology, Received 24 May 1990; and in revised form 29 August 1990
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