蕈样肉芽肿或类银屑病患者的局部氮芥治疗。

Topical nitrogen mustard therapy in patients with mycosis fungoides or parapsoriasis.

机构信息

Department of Dermatology, Aarhus University Hospital, Denmark.

出版信息

J Eur Acad Dermatol Venereol. 2013 Feb;27(2):163-8. doi: 10.1111/j.1468-3083.2011.04433.x. Epub 2012 Jan 9.

DOI:10.1111/j.1468-3083.2011.04433.x

PMID:22229501

Abstract

BACKGROUND

Topical nitrogen mustard is a chemotherapeutic agent used in treatment of mycosis fungoides (MF).

OBJECTIVE

To evaluate the response and side effects in patients with MF and parapsoriasis treated with topical nitrogen mustard.

METHODS

A retrospective study of treatment response in 116 patients diagnosed with MF and 71 patients with parapsoriasis and treated with topical nitrogen mustard from 1991 to 2009.

RESULTS

Overall response rate and complete response (CR) rate was 91.4% and 53.4% in patients with MF and 90.1% and 40.8% in patients with parapsoriasis, respectively. Relapse following CR was observed in 67.7% in patients with MF and 62.1% in patients with parapsoriasis. Freedom-from-relapse was higher in patients with T1-T2 than in T3 disease (P < 0.01). Progressive disease (PD) occurred in 25.0% and 26.8% in patients with MF and parapsoriasis, respectively. Progression-free survival was similar in patients with T1-T2 compared with T3 (P = 0.79) and T4 disease (P = 0.22) and lower in patients with parapsoriasis with <10% than >10% skin involvement (P = 0.05).

CONCLUSION

The present study confirms that topical nitrogen mustard is a safe and effective therapy. The treatment response in patients with parapsoriasis was not statistically different from the response in patients with MF. This supports, that parapsoriasis is not a distinct entity, but an early stage of MF. Nitrogen mustard should therefore still be considered as an important treatment modality in patients with early stages (parapsoriasis) and later stages of MF either as monotherapy or in combination with other topical or systemic therapies.

摘要

背景

局部氮芥是一种用于治疗蕈样真菌病（MF）的化疗药物。

目的

评估 MF 和副银屑病患者接受局部氮芥治疗的反应和副作用。

方法

回顾性分析 1991 年至 2009 年间接受局部氮芥治疗的 116 例 MF 患者和 71 例副银屑病患者的治疗反应。

结果

MF 患者的总缓解率和完全缓解（CR）率分别为 91.4%和 53.4%，副银屑病患者分别为 90.1%和 40.8%。CR 后复发率在 MF 患者中为 67.7%，在副银屑病患者中为 62.1%。T1-T2 期患者的无复发率高于 T3 期患者（P<0.01）。进展性疾病（PD）分别发生在 25.0%和 26.8%的 MF 和副银屑病患者中。T1-T2 期患者的无进展生存与 T3 期（P=0.79）和 T4 期（P=0.22）患者相似，而皮肤受累<10%的副银屑病患者的无进展生存低于皮肤受累>10%的患者（P=0.05）。