Anderson Norman H, Arcaro Julie B
Radiation Oncology, Robert Boissoneault Oncology Institute, Ocala, USA.
Cureus. 2019 Mar 1;11(3):e4161. doi: 10.7759/cureus.4161.
The aim of this study was to discern an abscopal effect by modifying the delivery of radiation for metastatic malignant melanoma. The effect would be directly evident with visible/radiographic regression of the disease and indirectly shown with an overall extension in survival and potential cure. Patients with locally advanced, metastatic palpable, or radiographic visible metastatic malignant melanoma were treated with twice-daily radiation therapy using a dose range of 100-135 centigray (cGy) per fraction. A 100% complete response/continued regression with no recurrence was achieved within the region of delivery for every patient so treated. Of those alive at three years, few demonstrate a progression of the disease. These results were achieved without the use of immunotherapy, created few side effects, and were accomplished at a fraction of the alternative's cost. Evidence of an immune-mediated response (abscopal effect) was commonly seen. Treatment was administered within acceptable dose ranges, historically used twice daily for other malignancies known to be sensitive to the effects of radiation.
本研究的目的是通过改变转移性恶性黑色素瘤的放疗方式来识别远隔效应。该效应将直接表现为疾病的可见/影像学消退，间接表现为生存期的整体延长和潜在治愈。局部晚期、可触及转移或影像学可见转移的恶性黑色素瘤患者接受每日两次的放射治疗，每次剂量范围为100 - 135厘戈瑞（cGy）。接受如此治疗的每位患者在放疗区域内均实现了100%的完全缓解/持续消退且无复发。在三年存活的患者中，很少有疾病进展的情况。这些结果是在未使用免疫疗法的情况下取得的，副作用很少，且成本仅为其他治疗方法的一小部分。常见免疫介导反应（远隔效应）的证据。治疗是在可接受的剂量范围内进行的，这是历史上常用于已知对放疗敏感的其他恶性肿瘤的每日两次的剂量。
