Neurological Clinic Research Unit, Institute of Molecular Medicine, Lisbon School of Medicine, Lisbon, Portugal.
Mov Disord. 2010 Jan 30;25(2):139-48. doi: 10.1002/mds.22855.
The report of an increased frequency of melanoma during the clinical development of rasagiline prompted a renewed interest in a possible association between skin cancer and Parkinson's disease (PD). The evaluation of this risk ended in a recommendation to perform a periodic dermatological examination as a follow-up measure of their treatment. The recognition of this safety concern lead to the need to clarify if the risk of skin cancer is indeed associated with PD and if levodopa or other anti-parkinsonian drugs might contribute to increase such risk. To answer these questions, we critically reviewed all clinical studies available concerning the association between skin cancer and PD. We found 26 studies on cancer occurrence in PD. The best data available suggest the risk of cancer is reduced in PD patients. However, specific cancers like thyroid and the female breast were reported at higher-than-expected rates. Additionally, it was suggested that PD patients have a higher frequency of melanoma and non-melanoma skin cancers than the general population. The data on non-melanoma skin cancer are less robust than the data on melanoma. Causal factors remain unknown. Due to the weak association between skin cancer and PD, no robust recommendation can be made regarding the need for periodic dermatological screening.
在雷沙吉兰的临床开发过程中报告黑色素瘤的频率增加,这促使人们重新关注皮肤癌与帕金森病(PD)之间可能存在的关联。对这种风险的评估最终建议进行定期皮肤科检查,作为其治疗的后续措施。对这种安全问题的认识导致需要澄清皮肤癌的风险是否确实与 PD 相关,以及左旋多巴或其他抗帕金森病药物是否可能增加这种风险。为了回答这些问题,我们对所有涉及皮肤癌与 PD 之间关联的临床研究进行了批判性审查。我们发现了 26 项关于 PD 中癌症发生的研究。现有最佳数据表明,PD 患者的癌症风险降低。然而,某些癌症,如甲状腺癌和乳腺癌的报告发病率高于预期。此外,有人认为 PD 患者的黑色素瘤和非黑色素瘤皮肤癌的发病率高于一般人群。非黑色素瘤皮肤癌的数据不如黑色素瘤的数据可靠。因果因素仍不清楚。由于皮肤癌与 PD 之间的关联较弱,因此不能就定期皮肤科筛查的必要性提出强有力的建议。