Garbe C
University Department of Dermatology, Medical Center Steglitz, Free University of Berlin, Germany.
Recent Results Cancer Res. 1995;139:349-69. doi: 10.1007/978-3-642-78771-3_27.
Cytokines have been tested in the treatment of different skin cancers during the last decade, and treatment schedules have been established or proposed for several malignant skin tumors. Preferentially, the interferons and interleukin-2 were found to be effective in treating skin cancers. Interferons alpha and beta have been approved for the treatment of human immunodeficiency virus (HIV)-associated Kaposi's sarcoma, cutaneous T cell lymphoma, and malignant melanoma in several countries. Interferon alpha was found to be most effective in cutaneous T cell lymphoma with 40%-60% overall responses. When combining interferon alpha with psoralens and ultraviolet A (PUVA) or with retinoids, even higher response rates up to 60%-90% were reported, and long-term remissions have been described. A considerable activity of interferon alpha was found in HIV-associated Kaposi's sarcoma with response rates of 30%-50%. The effectiveness of Kaposi's sarcoma's treatment was further improved by combining interferon alpha and zidovudine. Responses to interferon alpha in metastatic malignant melanoma are rather seldom (10%-15%), but a stabilization of the disease with prolonged survival was reported after interferon alpha treatment. Additionally, interleukin-2 was found to be active in metastatic melanoma, with overall response rates of about 20%, and both biological agents were found to have an additive efficacy in combination. Several combined regimens of interferon alpha, interleukin-2, and polychemotherapy have been described in metastatic melanoma, and overall response rates higher than 50% were found with these combined treatment modalities. Interferon alpha and beta were also intralesionally injected into basal cell carcinomas and other epithelial skin cancers, and complete responses were found in more than 80% of tumors treated. Local applications of interferons and interleukin-2 were likewise found to be effective in the treatment of cutaneous melanoma metastases and cutaneous manifestations of Kaposi's sarcoma. Cytokines and their combination with other treatment modalities has greatly enriched the treatment facilities in malignant skin tumors during recent years, and additional new cytokines will be introduced in skin cancer treatment in near future.
在过去十年中，细胞因子已被用于不同皮肤癌的治疗，并且已经为几种恶性皮肤肿瘤制定或提出了治疗方案。优先发现干扰素和白细胞介素-2在治疗皮肤癌方面有效。在几个国家，α干扰素和β干扰素已被批准用于治疗人类免疫缺陷病毒（HIV）相关的卡波西肉瘤、皮肤T细胞淋巴瘤和恶性黑色素瘤。发现α干扰素在皮肤T细胞淋巴瘤中最有效，总体缓解率为40%-60%。当α干扰素与补骨脂素和紫外线A（PUVA）或与维甲酸联合使用时，据报道缓解率甚至更高，可达60%-90%，并且有长期缓解的描述。在HIV相关的卡波西肉瘤中发现α干扰素有相当大的活性，缓解率为30%-50%。联合使用α干扰素和齐多夫定进一步提高了卡波西肉瘤的治疗效果。转移性恶性黑色素瘤对α干扰素的反应相当少见（10%-15%），但据报道α干扰素治疗后疾病稳定且生存期延长。此外，发现白细胞介素-2在转移性黑色素瘤中具有活性，总体缓解率约为20%，并且发现这两种生物制剂联合使用具有相加疗效。在转移性黑色素瘤中已经描述了几种α干扰素、白细胞介素-2和多药化疗的联合方案，并且这些联合治疗方式的总体缓解率高于50%。α干扰素和β干扰素也被瘤内注射到基底细胞癌和其他上皮性皮肤癌中，在超过80%接受治疗的肿瘤中发现了完全缓解。同样发现干扰素和白细胞介素-2的局部应用在治疗皮肤黑色素瘤转移和卡波西肉瘤的皮肤表现方面有效。近年来，细胞因子及其与其他治疗方式的联合极大地丰富了恶性皮肤肿瘤的治疗手段，并且在不久的将来将有更多新的细胞因子被引入皮肤癌治疗。
