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[皮肤卫星灶和移行转移灶完全缓解。2例恶性黑色素瘤患者经病灶内注射白细胞介素-2治疗后]

[Complete remission of cutaneous satellite and in-transit metastases. After intralesional therapy with interleukin-2 in 2 patients with malignant melanoma].

作者信息

Pföhler C, Steinhäuser S, Wagner A, Ugurel S, Tilgen W

机构信息

Hautklinik und Poliklinik, Universitätskliniken des Saarlandes, Homburg/Saar.

出版信息

Hautarzt. 2004 Feb;55(2):171-5. doi: 10.1007/s00105-003-0620-4.

DOI:10.1007/s00105-003-0620-4
PMID:14968328
Abstract

Multiple cutaneous satellite and in-transit metastases of melanoma without involvement of lymph nodes or other organs are a challenge especially when they occur in elderly inoperable patients with multiple internal diseases. In this particular situation, intralesional application of interleukin-2 may represent an effective alternative to systemic chemo- or immunotherapy as it can be performed on an out-patient basis and has few side effects. We treated two elderly female patients with multiple cutaneous metastases of malignant melanoma with intra- and perilesional application of interleukin-2 (3 x 6-12 Mio IE) over 12 weeks and achieved a complete remission of these metastases. In follow-up biopsies, no viable tumor cells were found. Despite a slight burning at the injection side and a transient local inflammatory reaction, the therapy was well tolerated in both cases after premedication with paracetamol 500 mg orally and pretreatment of the injection site with a cream containing lidocaine and prilocaine. No systemic side effects were observed.

摘要

黑色素瘤出现多发皮肤卫星灶及皮下转移,而无淋巴结或其他器官受累,这是一个挑战,尤其当发生在患有多种内科疾病、无法手术的老年患者身上时。在这种特殊情况下,病灶内注射白细胞介素-2可能是全身化疗或免疫治疗的有效替代方法,因为它可以在门诊进行,且副作用较少。我们对两名患有恶性黑色素瘤多发皮肤转移的老年女性患者,在12周内病灶内及病灶周围注射白细胞介素-2(3×600 - 1200万国际单位),这些转移灶完全缓解。在随访活检中,未发现存活的肿瘤细胞。尽管注射部位有轻微烧灼感和短暂的局部炎症反应,但在口服500毫克对乙酰氨基酚进行预处理以及用含有利多卡因和丙胺卡因的乳膏对注射部位进行预处理后,两名患者对该治疗耐受性良好。未观察到全身副作用。

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本文引用的文献

1
Topical imiquimod in the treatment of metastatic melanoma to skin.局部用咪喹莫特治疗皮肤转移性黑色素瘤。
Arch Dermatol. 2003 Mar;139(3):273-6. doi: 10.1001/archderm.139.3.273.
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Safety and efficacy of isolated limb perfusion in elderly melanoma patients.老年黑色素瘤患者肢体隔离灌注的安全性和有效性。
Ann Surg Oncol. 2002 Dec;9(10):968-74. doi: 10.1007/BF02574514.
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[Persistent inflammatory reaction at the injection site of Il-2 with lymphoma-like inflammatory infiltrates].[白细胞介素-2注射部位存在持续性炎症反应及淋巴瘤样炎性浸润]
Hautarzt. 2002 Aug;53(8):554-7. doi: 10.1007/s00105-001-0305-9.
4
Topical imiquimod eradicates skin metastases of malignant melanoma but fails to prevent rapid lymphogenous metastatic spread.局部使用咪喹莫特可根除恶性黑色素瘤的皮肤转移灶,但无法防止其通过淋巴系统迅速发生转移扩散。
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The impact of surgery on the course of melanoma.手术对黑色素瘤病程的影响。
Recent Results Cancer Res. 2002;160:151-7. doi: 10.1007/978-3-642-59410-6_18.
6
Intralesional granulocyte-monocyte colony-stimulating factor followed by subcutaneous interleukin-2 in metastatic melanoma: a pilot study in elderly patients.病灶内注射粒细胞-单核细胞集落刺激因子后皮下注射白细胞介素-2治疗转移性黑色素瘤:老年患者的一项初步研究
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8
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Melanoma Res. 2000 Dec;10(6):585-9. doi: 10.1097/00008390-200012000-00011.
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