Hersey P
Oncology and Immunology Unit, Newcastle Mater Hospital, Newcastle, New South Wales, Australia.
Intern Med J. 2003 Jan-Feb;33(1-2):33-43. doi: 10.1046/j.1445-5994.2002.00289.x.
Patients with thick, primary melanoma and regional lymph-node metastases are at moderate to high risk of recurrence and death, despite apparent complete surgical removal. Immune responses can be demonstrated against melanoma and this has prompted the conduct of a number of randomized trials of immunotherapy. Several trials have been completed and show minimal benefit in prolonging survival or recurrence from melanoma. Similarly, a large number of trials has been conducted to test the efficacy of alpha-2-interferon (IFN-alpha2) in therapy. Clear benefit in recurrence-free survival was shown in several trials, however there is a lack of convincing evidence of an effect on overall survival. Several trials of vaccine and IFN-alpha2 therapy are still in progress and their results are awaited with great interest. The use of high-dose IFN-alpha2 therapy remains a contentious subject, however available evidence suggests the standard of care remains good surgical management.
患有原发性厚黑色素瘤并伴有区域淋巴结转移的患者，尽管手术切除看似彻底，但仍有中度至高度的复发和死亡风险。针对黑色素瘤的免疫反应是可以被证实的，这促使了多项免疫疗法随机试验的开展。已有多项试验完成，结果显示在延长黑色素瘤患者生存期或预防复发方面益处甚微。同样，也进行了大量试验来测试α-2干扰素（IFN-α2）的治疗效果。多项试验表明其在无复发生存方面有明显益处，然而，缺乏令人信服的证据表明其对总生存期有影响。目前仍有多项疫苗和IFN-α2治疗试验正在进行中，人们对其结果拭目以待。高剂量IFN-α2治疗的应用仍然存在争议，不过现有证据表明，标准的治疗方法仍是良好的手术管理。
