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The Analysis of Post Operative Treatment of Malignant Melanoma Using High Dose Interferon-${\alpha}2b$ Immunotherapy: Preliminary Report

악성흑색종 환자군에서 수술적 치료 후 시행한 고용량 인터페론-${\alpha}2b$ 면역요법에 의한 보조적 치료 결과 분석: 예비보고

  • Chung, So Hak (Department of Orthopedic Surgery, Kosin University Gospel Hospital) ;
  • Jo, Hyun Ik (Department of Orthopedic Surgery, Kosin University Gospel Hospital)
  • 정소학 (고신대학교 복음병원 정형외과) ;
  • 조현익 (고신대학교 복음병원 정형외과)
  • Received : 2012.10.26
  • Accepted : 2012.11.27
  • Published : 2012.12.31

Abstract

Purpose: Interferon-${\alpha}2b$ using immunotherapy of malignant melanoma is known to increase the microscopic enemies that remain after surgical resection of the tumor to prevent recurrence, disease-free survival and overall survival. Authors in patients with malignant melanoma after surgical resection and high-dose interferon-${\alpha}$ immunotherapy treated group of disease-free survival and overall survival compared with the results of the treatment of immune therapy to a preliminary report. Materials and Methods: From February 2010 to October 2012 at our institution between being diagnosed with malignant melanoma after surgical immunotherapy treated patients were analyzed. Patients was evaluated using the stage AJCC stage IIA 3 cases, IIB 1 cases, IV 1 were as follows. Follow-up period of at least 7 months, and a maximum of 32 months. As maintenance therapy after the first induction therapy group underwent immunotherapy interferon-${\alpha}$ of body-surface area per 200,000 IU five times in a week for 4 weeks sedentary and body surface area a total of 48 weeks per week to 100,000 IU three times subcutaneously. These patients for local recurrence and metastases, and distant metastasis were investigated disease-free survival was investigated. Results: Interferon-evaluation through follow-up chest computed tomography (CT) and positron emission computed tomography (PET CT) in patients who underwent the ${\alpha}$ immunotherapy results above both local recurrence and metastases without evidence of distant metastases. Conclusion: The high-dose ${\alpha}2b$ immunotherapy performed in patients to prevent the local recurrence of the tumor and metastasis to the current or future ultimate survival and disease-free survival improvement achieved is additional study and follow-up will be needed.

목적: 고용량 인터페론-${\alpha}2b$를 이용한 악성흑색종의 면역요법은 외과적 절제술 후 현미경적 적이나 남아있는 종양의 재발을 막고 무병생존율과 전체 생존율을 높이는 것으로 알려져 있다. 저자 등은 악성 흑색종 환자군에서 외과적 절제술 후 고용량 인터페론-${\alpha}$ 면역요법을 시행한 그룹의 무병생존기간 및 전체 생존율 등을 비교 분석하여 면역요법의 치료결과를 예비 보고하고자 한다. 대상 및 방법: 2010년 2월부터 2012년 10월까지 본원에서 악성 흑색종으로 진단받고 외과적 수술 후 면역치료를 시행한 5명을 대상으로 분석 하였다. 병기는 AJCC 병기를 이용하여 판정하였으며 IIA 3예, IIB 1예, IV 1예로 나타났다. 추시기간은 최소 7개월에서 최대 32개월이었다. 면역 요법을 시행한 군에서는 먼저 유도요법으로 ${\alpha}2b$를 체표면적 당 20만 IU를 총 4주간 1주일에 5회 정주하였으며 이후 유지요법으로 체표면적당 10만 IU를 총 48주간 1주일에 3회 피하주사하였다. 이들 환자들에 대해 국소재발과 국소전이, 그리고 원격전이여부를 조사하였고 무병생존기간을 조사하였다. 결과: 인터페론-${\alpha}2b$ 면역요법을 시행한 환자군에서 추시 흉부 전산화 단층촬영 및 양전자 컴퓨터 단층촬영을 통한 평가 결과 현재까지 모두 국소 재발 및 국소전이 원격전이의 증거가 없는 것으로 나타났다. 결론: 고용량 인터페론-${\alpha}$ 면역요법 시행군에서 현재까지 종양의 국소 재발 및 전이를 막는 것으로 나타났으나 향후 궁극적인 생존율 및 무병생존율 향상이 달성되는가에 대해서는 추가적인 연구대상과 추적관찰이 필요하겠다.

Keywords

References

  1. Gray RJ, Pockaj BA, Kirkwood JM. An update on adjuvant interferon for melanoma. Cancer Control. 2002;9:16-21.
  2. Rigel DS, Carucci JA. Malignant melanoma: prevention, early detection, and treatment in the 21st century. CA Cancer J Clin. 2000;50:215-36.
  3. Booher RJ, Pack GT. Malignant melanoma of the feet and hands. Surgery. 1957;42:1085-121.
  4. Ferlay J, Bray F, Pisani P, Parkin DM. Globocan 2000: Cancer incidence, mortality and prevalence worldwide, version 1.0. IARC cancer base no. 5. Lyon: IARC Press; 2001.
  5. Kim DS, Kim BJ. Two cases of malignant melanoma. J Korean Orthop Assoc. 1976;11:397-402.
  6. Lee JL, Kim YH, Lee JM, Kim JD, Kim SJ, Park JH. Molecular analysis of HLA-DR gene expression induced by IFN-gamma in malignant melanoma cell lines. Yonsei Med J. 1999;40:30-9.
  7. Kleeberg UR, Broker EB, Lejeune F, et al. Adjuvant trial in melanoma patients comparing rIFN-alpha to rIFN-gamma Iscador to a control group after curative resection of high risk primary (>3 mm) or regional lymphnode metastasis (EORTC 18871). Eur J Cancer. 1999;35(suppl 4):A-264, S82.
  8. Kirkwood JM, Strawderman MH, Ernstoff MS, Smith TJ, Borden EC, Blum RH. Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684. J Clin Oncol. 1996;14:7-17.
  9. Kirkwood JM, Ibrahim JG, Sondak VK, et al. High- and lowdose interferon alfa-2b in high-risk melanoma: first analysis of intergroup trial E1690/S9111/C9190. J Clin Oncol. 2000;18:2444-58.
  10. Cole BF, Gelber RD, Kirkwood JM, Goldhirsch A, Barylak E, Borden E. Quality-of-life-adjusted survival analysis of interferon alfa-2b adjuvant treatment of high-risk resected cutaneous melanoma: an Eastern Cooperative Oncology Group study. J Clin Oncol. 1996;14:2666-73.
  11. Eggermont AMM, Kleeberg UR, Ruiter DJ, et al. European Organization for Research and Treatment of Cancer Melanoma Group trial experience with more than 2,000 patients, evaluating adjuvant treatment with low or intermediate doses of interferon alpha-2b. American Society of Clinical Oncology Educational Book. Alexandria, VA: American Society of Clinical Oncology; 2001. 88-93.
  12. Kirkwood J, Hunt M, Smith T, et al. A randomised controlled trial of high dose interferon a2b for high risk melanoma. Proc Am Soc Clin Oncol. 1993;12:390.