Hauschild A, Osterkamp G, Clausen M, Christophers E
Hautklinik, Christian-Albrechts-Universität Kiel.
Dtsch Med Wochenschr. 1993 Mar 12;118(10):336-40. doi: 10.1055/s-2008-1059334.
A 47 year old woman underwent excision of a malignant melanoma on the right shoulder. Nine years later she was attacked by intense pain in the back. Computed tomography, bone scans and immunohistochemical study of a liver biopsy specimen revealed metastases from the malignant melanoma in the liver, spleen and skeleton. Her Karnovsky score was 50%. Chemoimmunotherapy given for five cycles consisting of dacarbazine (800 mg/m2 body surface area every 4 weeks) together with ambulatory cytokine therapy (interferon alpha-2b subcutaneously, 5 million I.U. on days 1 and 3 to 7 in the first week, days 1, 3 and 5 in the second and third weeks and interleukin 2.9 million I.U. on days 1 to 5 in the second and third weeks; no treatment was given in the fourth week) raised the Karnovsky score to 90% and abolished the pain. Lactate dehydrogenase activity, originally 3372 U/l, dropped to normal. Computed tomography demonstrated definite shrinkage of the liver metastases and some regression of the splenic and bony deposits. This improvement has now been maintained for a total of eight cycles of therapy.
一名47岁女性接受了右肩部恶性黑色素瘤切除术。九年后，她背部剧痛。计算机断层扫描、骨扫描以及肝脏活检标本的免疫组化研究显示，肝脏、脾脏和骨骼出现了恶性黑色素瘤转移。她的卡氏评分是50%。进行了五个周期的化学免疫疗法，包括达卡巴嗪（每4周800毫克/平方米体表面积），同时进行门诊细胞因子治疗（皮下注射干扰素α-2b，第一周第1天和第3至7天为500万国际单位，第二周和第三周第1、3和5天为500万国际单位，第二周和第三周第1至5天为白细胞介素2 900万国际单位；第四周不进行治疗），这使卡氏评分提高到90%并消除了疼痛。乳酸脱氢酶活性原本为3372 U/l，降至正常水平。计算机断层扫描显示肝脏转移灶明显缩小，脾脏和骨转移灶有所消退。这种改善目前在总共八个周期的治疗中得以维持。
