Gray Richard J, Pockaj Barbara A, Kirkwood John M
Division of General Surgery, Mayo Clinic, Arizona, USA.
Cancer Control. 2002 Jan-Feb;9(1):16-21. doi: 10.1177/107327480200900103.
Despite advances in the staging and surgical therapy of melanoma, patients with high-risk resected melanoma still have 5-year recurrence rates of 55% to 80% and 5-year survival rates as low as 25% to 70%. Effective adjuvant therapy is needed for this patient population.
The authors review the literature regarding the use of interferon for the adjuvant therapy of resected melanoma.
Low-dose adjuvant interferon regimens have not affected overall survival and have had an inconsistent effect on disease-free survival across different stage groupings. High-dose adjuvant interferon improved disease- free and overall survival in the E1684 and Intergroup E1694 trials. High-dose interferon regimens cause significant morbidity, but quality-adjusted years of life are greater with this therapy.
Adjuvant high-dose interferon should be considered standard therapy for all high-risk melanoma patients expected to be able to tolerate the interferon and treated off protocol. In addition, this regimen should serve as the active control in future trials of alternative adjuvant therapies for these patients.
尽管黑色素瘤的分期和手术治疗取得了进展，但高危切除性黑色素瘤患者的5年复发率仍为55%至80%，5年生存率低至25%至70%。这一患者群体需要有效的辅助治疗。
作者回顾了关于干扰素用于切除性黑色素瘤辅助治疗的文献。
低剂量辅助干扰素方案未影响总生存期，且在不同分期组中对无病生存期的影响不一致。在E1684和E1694协作组试验中，高剂量辅助干扰素改善了无病生存期和总生存期。高剂量干扰素方案会导致显著的发病率，但这种治疗的质量调整生命年更长。
辅助高剂量干扰素应被视为所有预期能够耐受干扰素且未按方案治疗的高危黑色素瘤患者的标准治疗方法。此外，该方案应作为未来这些患者替代辅助治疗试验的活性对照。
