Eastern Virginia Medical School, Norfolk, VA, USA.
Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
Arch Dermatol Res. 2024 May 25;316(6):244. doi: 10.1007/s00403-024-03107-9.
Melanoma, accounting for a significant proportion of skin cancer-related deaths, has variable survival outcomes based on the stage at diagnosis and treatment efficacy. Traditional treatments, while effective, pose risks of scarring and systemic side effects. Laser therapy offers an emerging non-surgical alternative, with CO2 lasers particularly showing promise in palliative care.A comprehensive search was conducted using PubMed, focusing on laser therapy for melanoma treatment. The search included studies on both stand-alone and adjunct laser therapies, with inclusion criteria requiring peer-reviewed articles detailing treatment outcomes for primary, recurrent, or metastatic melanoma.The literature shows that laser therapy for melanoma falls into four major types when categorized by laser medium: solid-state, diode, pulse-dye, and gas (CO2). Data on solid-state lasers for melanoma are limited and their use remains controversial. However, one study with high-energy pulsed neodymium lasers reported a 5-year survival of 82.9% with minimal adverse effects for primary melanoma. CO2 laser therapy has been effective for palliative treatment, with one study showing 54.8% of patients with recurrent melanoma surviving 5.4 years post-ablation. For metastatic melanoma, numerous studies have shown that CO2 laser therapy can provide symptomatic relief and disease control. Combination therapies using lasers and immune-based therapies have demonstrated enhanced outcomes and immune activation, highlighting the potential of laser therapies in melanoma management.While traditional treatments remain the standard for primary melanoma, laser therapies, particularly CO2 laser ablation, show substantial promise in palliative care for metastatic melanoma. Careful patient selection and assessment are crucial for achieving positive outcomes.
黑色素瘤是导致皮肤癌相关死亡的主要原因之一,其生存率因诊断时的阶段和治疗效果而异。传统治疗方法虽然有效,但存在疤痕和全身副作用的风险。激光治疗提供了一种新兴的非手术替代方法,其中 CO2 激光在姑息治疗中尤其有前景。我们使用 PubMed 进行了全面搜索,重点关注激光治疗黑色素瘤的研究。搜索包括独立和辅助激光治疗的研究,纳入标准要求详细描述原发性、复发性或转移性黑色素瘤治疗结果的同行评审文章。文献表明,根据激光介质的不同,激光治疗黑色素瘤可分为四大类:固体、二极管、脉冲染料和气体(CO2)。关于 CO2 激光治疗黑色素瘤的研究数据有限,其应用仍存在争议。然而,一项使用高能脉冲钕激光器的研究报告称,原发性黑色素瘤的 5 年生存率为 82.9%,不良反应最小。CO2 激光治疗在姑息治疗中已被证明有效,一项研究显示 54.8%的复发性黑色素瘤患者在消融后 5.4 年内存活。对于转移性黑色素瘤,多项研究表明 CO2 激光治疗可以提供症状缓解和疾病控制。激光治疗与免疫治疗的联合疗法已显示出增强的疗效和免疫激活,突出了激光疗法在黑色素瘤管理中的潜力。虽然传统治疗仍是原发性黑色素瘤的标准治疗方法,但激光疗法,特别是 CO2 激光消融,在转移性黑色素瘤的姑息治疗中显示出很大的潜力。仔细选择和评估患者对于获得良好的治疗结果至关重要。