Lippman S M, Shimm D S, Meyskens F L
Department of Internal Medicine, University of Arizona Cancer Center, Tucson 85724.
J Dermatol Surg Oncol. 1988 Aug;14(8):862-9. doi: 10.1111/j.1524-4725.1988.tb03590.x.
Retinoids, the natural and synthetic analogs of vitamin A, and alpha-interferon have been used effectively in the treatment of certain cutaneous premalignancies and malignancies. Retinoids have shown impressive activity against premalignant disorders of the skin (actinic keratoses, keratoacanthoma, epidermodysplasia verruciformis) and of other epithelial sites (oral leukoplakia, cervical dysplasia). In established basal cell skin cancers, topical retinoid treatment has produced a complete response rate of 33%, and systemic retinoids have produced an objective response rate of 51%. In advanced squamous cell skin cancers, systemic retinoids have produced a response rate of over 70%. Intralesional alpha-interferon has produced impressive responses and systemic alpha-interferon has produced a 50% objective response rate in basal and squamous cell carcinoma. Retinoid therapy and alpha-interferon have produced modest overall results in melanoma, although striking individual responses have been reported. In cutaneous T-cell lymphoma, which is notably refractory to chemotherapy, retinoids and alpha-interferon have produced responses in 60%+ and 70%+ of cases, respectively. Retinoids and alpha-interferon, either alone or in combination, offer exciting prospects for primary and neoadjuvant therapy for advanced malignancy. Retinoids also show promise as relatively nontoxic preventive and adjuvant therapy. Researchers should focus on integrating these drugs with other biological response modifiers, differentiation agents, and cytotoxic drugs for treating advanced malignancy.
类视黄醇，即维生素A的天然和合成类似物，以及α-干扰素已有效地用于治疗某些皮肤癌前病变和恶性肿瘤。类视黄醇已显示出对皮肤癌前疾病（光化性角化病、角化棘皮瘤、疣状表皮发育不良）以及其他上皮部位（口腔白斑、宫颈发育异常）具有显著活性。在已确诊的基底细胞皮肤癌中，局部应用类视黄醇治疗的完全缓解率为33%，全身应用类视黄醇的客观缓解率为51%。在晚期鳞状细胞皮肤癌中，全身应用类视黄醇的缓解率超过70%。病灶内注射α-干扰素已产生显著疗效，全身应用α-干扰素在基底细胞癌和鳞状细胞癌中的客观缓解率为50%。类视黄醇疗法和α-干扰素在黑色素瘤治疗中总体效果一般，尽管有显著的个体反应报道。在对化疗明显耐药的皮肤T细胞淋巴瘤中，类视黄醇和α-干扰素分别在60%以上和70%以上的病例中产生了反应。类视黄醇和α-干扰素单独或联合使用，为晚期恶性肿瘤的一线治疗和新辅助治疗提供了令人兴奋的前景。类视黄醇作为相对无毒的预防和辅助治疗也显示出前景。研究人员应专注于将这些药物与其他生物反应调节剂、分化剂和细胞毒性药物整合，用于治疗晚期恶性肿瘤。
