TREATMENT OF MELANOMA BY ISOLATION-PERFUSION TECHNIQUE

Metastatic melanoma on the lower extremity has been treated in eight patients by a new technique with use of phenylalanine mustard. An extracorporeal circulation system, consisting of a pump and a disposable oxygenator, was connected either with the common femoral artery and vein or with the external iliac artery and vein so as to achieve vascular isolation of the extremity. This system was then perfused with the phenylalanine mustard for one hour, after which it was flushed out and normal circulation was restored. The characteristic response of cutaneous metastases was a sequence of changes, in that they became blacker and flattened, a crust formed on the surface, and finally the lesion dropped off, leaving a light freckle. Not all melanomas responded in this way, but some lesions regressed strikingly and several disappeared completely. When the vascular isolation of the lower extremity was effective, the amount of phenylalanine mustard used (2 mg. or less per kilogram of body weight) did not seriously depress hematopoesis.