Dummer R, Nestle F O, Hofbauer G, Böni R, Burg G
Dermatologische Klinik, Universitäts-Spital Zürich.
Ther Umsch. 1998 Aug;55(8):509-14.
Therapy of melanoma considers the individual prognosis. Primary low-risk melanomas with tumor-thickness below 1 mm can be treated by surgery with a safety margin of 1 cm. If the tumor-thickness is more than 2 mm the safety margin should be 3 cm. Elective lymph node dissection for melanomas at the extremities is widely substituted by the sentinel lymph node procedure. This new technique shall be applied only in specialised centers in the context of clinical trials. After the resection of lymph node metastases adjuvant treatment using Interferon-alpha should be considered. Palliative therapy of metastases includes surgery, radiotherapy and chemo-immunotherapy depending on the number and location of the metastases. Recent progress in understanding the immunobiology of melanoma and the development of gene therapy has offered new perspectives for future therapeutical intervention including peptide vaccination alone or loaded on dendritic cells and gene therapy.
黑色素瘤的治疗需考虑个体预后。肿瘤厚度小于1mm的原发性低风险黑色素瘤可通过手术治疗，安全切缘为1cm。如果肿瘤厚度超过2mm，安全切缘应为3cm。肢体黑色素瘤的选择性淋巴结清扫术已广泛被前哨淋巴结活检术所取代。这项新技术仅应在临床试验的背景下应用于专业中心。切除淋巴结转移灶后，应考虑使用α干扰素进行辅助治疗。转移灶的姑息治疗包括手术、放疗和化学免疫疗法，具体取决于转移灶的数量和位置。黑色素瘤免疫生物学理解方面的最新进展以及基因治疗的发展为未来的治疗干预提供了新的视角，包括单独的肽疫苗接种或负载于树突状细胞上的肽疫苗接种以及基因治疗。
