To review the current role of regional chemotherapy in the management of advanced limb melanoma. Articles reporting the results of isolated limb infusion (ILI) were identified by performing a comprehensive literature search using the PubMed database. Keywords included isolated limb infusion, in-transit melanoma and melphalan. No publication date restrictions were applied. ILI data were compared with those from current systemic therapy clinical trials and the previously reviewed isolated limb perfusion (ILP) literature. Regional chemotherapy is today required in fewer patients because effective systemic therapies now provide an alternative treatment for those who develop extensive local melanoma recurrence or in-transit metastases (ITMs). However, regional chemotherapy may be a valuable treatment option when the side-effects of systemic therapies are of concern, or after systemic treatment failure. ILP achieves overall response rates (ORRs) of 64-100% and complete response rates (CRRs) of 25-89%. ILI achieves ORRs of 41-91% and CRRs of 6-39%. ILP and ILI can have a low risk of serious morbidity. Early results from treatment with ILP or ILI in conjunction with systemic immune therapies suggest that these modalities can be safely combined, which may be useful in patients with refractory limb disease. Regional chemotherapy remains important in the armamentarium of clinicians managing patients with unresectable limb melanoma and may be preferable in those who are frail, elderly or who are at high risk from complications of systemic therapies. The efficacy of combining regional chemotherapy with systemic immune therapy is currently being assessed.

中文翻译：

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在潜在有效的全身治疗时代，局部化疗对晚期肢体黑色素瘤的作用。

回顾当前区域化疗在晚期肢体黑色素瘤治疗中的作用。通过使用 PubMed 数据库进行全面的文献检索，确定了报告离体肢体输注 (ILI) 结果的文章。关键词包括孤立肢体输注、转运黑色素瘤和马法兰。没有发布日期限制。将 ILI 数据与当前全身治疗临床试验和之前审查的孤立肢体灌注 (ILP) 文献的数据进行比较。如今，需要局部化疗的患者越来越少，因为有效的全身疗法现在为那些出现广泛的局部黑色素瘤复发或途中转移 (ITM) 的患者提供了替代治疗。然而，当担心全身治疗的副作用或全身治疗失败后，区域化疗可能是一种有价值的治疗选择。ILP 的总体缓解率 (ORR) 为 64-100%，完全缓解率 (CRR) 为 25-89%。ILI 的 ORR 为 41-91%，CRR 为 6-39%。ILP 和 ILI 严重发病的风险较低。ILP 或 ILI 治疗与全身免疫疗法相结合的早期结果表明，这些疗法可以安全地联合使用，这可能对难治性肢体疾病患者有用。区域化疗对于治疗不可切除的肢体黑色素瘤患者的临床医生来说仍然很重要，并且对于体弱、年老或全身治疗并发症风险较高的患者可能更可取。目前正在评估局部化疗与全身免疫治疗相结合的疗效。