Terheyden P, Kortüm A-K, Schulze H-J, Durani B, Remling R, Mauch C, Junghans V, Schadendorf D, Beiteke U, Jünger M, Becker J C, Bröcker E-B
Department of Dermatology, University of Würzburg, Josef-Schneider Str. 2, 97080 Würzburg, Germany.
J Cancer Res Clin Oncol. 2007 Jul;133(7):437-44. doi: 10.1007/s00432-006-0182-9. Epub 2007 Mar 3.
To scrutinize published data from small mono-centric studies and case reports which implicated high response rates and promising survival times for a combination therapy consisting of epifocal dinitrochlorobenzene (DNCB) and dacarbazine (DTIC) for metastasized melanoma. This therapy merges the effects of an allergic contact dermatitis elicited at the site of a cutaneous metastasis, and systemic chemotherapy.
We performed a retrospective survey with nine German centers and evaluated 72 patients treated from 1993 to 2005.
The objective response rate in stage III melanoma (n = 39) was 62%. In contrast, only 9% objective responses were observed in 33 stage IV patients. Interestingly, more than half of patients with objective remissions remained progression-free for more than 1 year irrespective of the stage of disease.
Epifocal DNCB combined with DTIC is effective in patients with regionally metastasized melanoma not amenable to surgery or isolated limb perfusion, whereas in stage IV disease in spite of few durable remissions the addition of DNCB does not improve the therapeutic efficacy of DTIC.
仔细审查已发表的来自小型单中心研究和病例报告的数据，这些数据表明，对于转移性黑色素瘤，由表皮聚焦二硝基氯苯（DNCB）和达卡巴嗪（DTIC）组成的联合疗法具有高缓解率和有前景的生存时间。该疗法融合了在皮肤转移部位引发的过敏性接触性皮炎的效应和全身化疗的效应。
我们对9个德国中心进行了一项回顾性调查，并评估了1993年至2005年期间接受治疗的72例患者。
III期黑色素瘤患者（n = 39）的客观缓解率为62%。相比之下，33例IV期患者中仅观察到9%的客观缓解。有趣的是，无论疾病处于何阶段，超过一半的获得客观缓解的患者无进展生存期超过1年。
表皮聚焦DNCB联合DTIC对不适合手术或孤立肢体灌注的局部转移性黑色素瘤患者有效，而在IV期疾病中，尽管有少数持久缓解，但添加DNCB并不能提高DTIC的治疗效果。
