Campbell Ross M, DiGiovanna John J
Division of Dermatopharmacology, Department of Dermatology, Brown Medical School and Rhode Island Hospital, Providence, Rhode Island 02903, USA.
Dermatol Ther. 2006 Sep-Oct;19(5):306-14. doi: 10.1111/j.1529-8019.2006.00088.x.
Systemic retinoids (isotretinoin, etretinate, and acitretin) have been shown to be effective chemotherapeutic agents in studies of patients with xeroderma pigmentosum, the nevoid basal cell carcinoma syndrome, and recipients of organ or bone marrow transplantation. In addition, patients who do not have these disorders but who are actively developing large numbers of new skin cancers may also benefit from this approach. All patients developing large numbers of skin cancers need rigorous UV protection and frequent dermatologic examinations. Although isotretinoin and acitretin share overlapping toxicities, there are differences that may affect drug choice. Because low doses may be effective, there are advantages to beginning treatment at a low dose, and subsequently, increasing dose if necessary, based on patient response. Laboratory monitoring including pregnancy testing should be performed before and during treatment. Long-term toxicity, primarily involving the skeletal system, can be monitored with imaging studies.
在对色素性干皮病、痣样基底细胞癌综合征患者以及器官或骨髓移植受者的研究中，全身性维甲酸（异维甲酸、阿维A酯和阿维A）已被证明是有效的化疗药物。此外，没有这些疾病但正在大量新发皮肤癌的患者也可能从这种方法中获益。所有大量发生皮肤癌的患者都需要严格的紫外线防护和频繁的皮肤科检查。虽然异维甲酸和阿维A有重叠的毒性，但也存在可能影响药物选择的差异。由于低剂量可能有效，基于患者反应，先以低剂量开始治疗，必要时随后增加剂量有其优势。治疗前和治疗期间应进行包括妊娠试验在内的实验室监测。长期毒性主要累及骨骼系统，可通过影像学检查进行监测。
