Therapie von Hautmetastasen beim malignen Melanom

Abstract

Malignant melanoma represents a particular challenge for dermatologists and oncologists because of its high and increasing incidence and the poor prognosis of patients with thick primary tumors (T3, T4). In advanced stages of melanoma, cutaneous and subcutaneous metastases have a special significance, as they markedly affect the patient and may lead to a limitation in quality of life. While topical therapy is possible, there are only limited clinical studies. The location, number, size and distribution of skin metastases, involvement of internal organs, age and general condition should be considered in assessing therapeutic options. Especially with solitary, easily accessible metastases, surgical excision represents the therapy of choice. Ablation using CO(2) laser is an alternative. With extensive metastases in just one extremity, isolated limb perfusion (ILP) with melphalan is an option, while multiple, smaller metastases can be irradiated. Further, several chemotherapeutic agents and immune modulators can be used topically, peri- and intralesionally.

Systemic therapy of disseminated malignant melanoma: an evidence‐based overview of the state‐of‐the‐art in daily routine

“…interleukin-2 (IL-2) inhalation against lung metastases, perfusion or embolization of liver metastases, immunotherapies of cutaneous metastases with DNCB, interferon-α (IFN-α ), IFN-β , Aldara and IL-2, intrathecal IL-2 applications, isolated limb perfusions, hyperthermias] as well as other local treatment options are published elsewhere. [8][9][10][11][12][13] This overview provides an evaluation of current melanoma therapies, a critical account of chemotherapy protocols and drugs as a basis for clinical practice and for a comparison to new developments.…”

“…Individualized treatments [e.g. interleukin‐2 (IL‐2) inhalation against lung metastases, perfusion or embolization of liver metastases, immunotherapies of cutaneous metastases with DNCB, interferon‐α (IFN‐α), IFN‐β, Aldara and IL‐2, intrathecal IL‐2 applications, isolated limb perfusions, hyperthermias] as well as other local treatment options are published elsewhere 8–13 …”