[Clinical evaluation of the efficacy of modern first, second, and third line regimes of chemotherapy in patients with disseminated cutaneous melanoma].

The effectiveness and side-effects of various chemotherapy (CT) regimens were compared in 157 patients (74 males and 80 females, aged 23-79) with disseminated skin melanoma (DSM). Most cases had multiple metastases to the skin and subcutaneous fat tissue, regional lymph nodes (59-69%), lung (14-38%) and liver (13-36%); to other sites--82 (52%). Total response in the dacarbazine (DTIC) group was 18% (complete--5, partial--13 and stabilization--29%). DTIC was employed as first-line treatment in 71%. DBDT (cisplatin, DTIC, BCNU, tamoxifen) was used in 42 patients: as first-line--13 (31%), second-line--21 (50%) and third-line (following the first two regimens in cases refractory to treatment or those with response-based evidence of tumor progression)--8 (19%). In DBDT-treated patients, total response was 29% (complete--7, partial 22 and stabilization--38%). Similar results were recorded in the group where 69% were given CT as second- and third-line treatment. The effect of CVD (cisplatin, vinblastin, DTIC) was much the same as that of DTIC alone but was followed by a higher incidence of myelodepression and anemia. Combined treatment with prospidin+ CCNU + BCNU seems to offer more advantage.