皮肤T细胞淋巴瘤局部用药和物理治疗的研究进展
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摘要
皮肤T细胞淋巴瘤(cutaneous T cell lymphoma,CTCL)大多属于惰性淋巴瘤,病情进展缓慢,患者确诊时多处于疾病早期。局部用药和物理治疗在CTCL治疗中占重要地位,包括局部外用皮质类固醇激素、免疫抑制剂、维A酸,放疗及光疗等。近年来,有研究对CTCL传统局部用药和物理治疗方法的有效性和安全性进行了重新评估。同时,新型CTCL局部用药和物理治疗策略也不断涌现,如局部外用他扎罗汀、瑞喹莫特,紫外线A联合新型光敏剂的光化学疗法和光动力治疗等。本文对CTCL局部用药和物理治疗的研究进展作一综述。
Cutaneous T cell lymphoma(CTCL) are mostly indolent,which slowly progress. The patients usually get a definite diagnosis in the early stage. Topical medication and physical therapy are the mainstays in the treatment of CTCL,including topical corticosteroids,immunosuppressive agents,retinoids,radiation therapy,and phototherapy. In recent years,the efficacy and safety of traditional methods has been further evaluated. Meanwhile,some new strategies of topical medication and physical therapy such as topical tazarotene,topical resiquimod,ultraviolet A plus new photosensitizer,and photodynamic therapy have been employed for CTCL. This article reviewed the research progress of topical medication and physical therapy for CTCL.
Cutaneous T cell lymphoma(CTCL) are mostly indolent,which slowly progress. The patients usually get a definite diagnosis in the early stage. Topical medication and physical therapy are the mainstays in the treatment of CTCL,including topical corticosteroids,immunosuppressive agents,retinoids,radiation therapy,and phototherapy. In recent years,the efficacy and safety of traditional methods has been further evaluated. Meanwhile,some new strategies of topical medication and physical therapy such as topical tazarotene,topical resiquimod,ultraviolet A plus new photosensitizer,and photodynamic therapy have been employed for CTCL. This article reviewed the research progress of topical medication and physical therapy for CTCL.
引文
[1]Talpur R,Venkatarajan S,Duvic M.Mechlorethamine gel for the topical treatment of stage IA and IB mycosis fungoidestype cutaneous T-cell lymphoma[J].Expert Rev Clin Pharmacol,2014,7:591-597.
[2]罗毅鑫,刘洁.皮肤T细胞淋巴瘤靶向治疗的研究进展[J].临床皮肤科杂志,2016,45:814-817.
[3]Nguyen CV,Bohjanen KA.Skin-Directed Therapies in Cutaneous T-Cell Lymphoma[J].Dermatol Clin,2015,33:683-696.
[4]Zackheim HS.Treatment of patch-stage mycosis fungoides with topical corticosteroids[J].Dermatol Ther,2003,16:283-287.
[5]Liu DY,Shaath T,Rajpara AN,et al.Safe and Efficacious Use of Intralesional Steroids for the Treatment of Focally Resistant Mycosis Fungoides[J].J Drugs Dermatol,2015,14:466-470.
[6]Lessin SR,Duvic M,Guitart J,et al.Topical chemotherapy in cutaneous T-cell lymphoma:positive results of a randomized,controlled,multicenter trial testing the efficacy and safety of a novel mechlorethamine,0.02%,gel in mycosis fungoides[J].JAMA Dermatol,2013,149:1-8.
[7]Benjamin CA,Markel K,Tawa MC.Optimizing Care and Compliance for the Treatment of Mycosis Fungoides Cutaneous T-Cell Lymphoma With Mechlorethamine Gel[J].Clin J Oncol Nurs,2015,19:E131-E139.
[8]Lindahl LM,Fenger-Gron M,Iversen L.Topical nitrogen mustard therapy in patients with mycosis fungoides or parapsoriasis[J].J Eur Acad Dermatol Venereol,2013,27:163-168.
[9]单百卉,李雪,郑玉洁,等.口服阿维A联合氮芥外用治疗老年蕈样肉芽肿1例[J].中国老年学,2013,33:1155-1156.
[10]Lindahl LM,Fengergrn M,Iversen L.Secondary cancers,comorbidities and mortality associated with nitrogen mustard therapy in patients with mycosis fungoides:a 30-year populationbased cohort study[J].Br J Dermatol,2014,170:699-704.
[11]Apisarnthanarax N,Wood GS,Stevens SR,et al.Phase Iclinical trial of O6-benzylguanine and topical carmustine in the treatment of cutaneous T-cell lymphoma,mycosis fungoides type[J].Arch Dermatol,2012,148:613-620.
[12]Macarthur KM,Jariwala N,Kim EJ,et al.Topical Carmustine as Monotherapy or as Multimodality Therapy for Folliculotropic Mycosis Fungoides[J].Acta Derm Venereol,2017,97:373-374.
[13]Heisig M,Maj J,Szepietowski JC,et al.Durable remission of folliculotropic mycosis fungoides achieved with a combined topical treatment with cytarabine and carmustine[J].Dermatol Ther,2015,29:15-18.
[14]Apisarnthanarax N,Talpur R,Ward S,et al.Tazarotene0.1% gel for refractory mycosis fungoides lesions:an open-label pilot study[J].J Am Acad Dermatol,2004,50:600-607.
[15]Besner MC,Roberge D,Turchin I,et al.Tazarotene 0.1% Cream as Monotherapy for Early-Stage Cutaneous T-Cell Lymphoma[J].J Cutan Med Surg,2016,20:244-248.
[16]Coors EA,Von d DP.Treatment of 2 patients with mycosis fungoides with alitretinoin[J].J Am Acad Dermatol,2012,67:e265-e267.
[17]Miernik B,Schmidt V,Technau-Hafsi K,et al.Alitretinoin in the treatment of palmoplantar mycosis fungoides:a new and promising therapeutic approach[J].Clin Exp Dermatol,2014,40:445-447.
[18]Bassiri-Tehrani S,David E.Treatment of cutaneous T-cell lymphoma with alitretinoin gel[J].Int J Dermatol,2002,41:104-106.
[19]Gordon MC,Sluzevich JC,Jambusariapahlajani A.Clearance of folliculotropic and tumor mycosis fungoides with topical 5%imiquimod[J].JAAD Case Rep,2015,1:348-350.
[20]Rook AH,Gelfand JC,Wysocka M,et al.Topical resiquimod can induce disease regression and enhance T-cell effector functions in cutaneous T-cell lymphoma[J].Blood,2015,126:1452.
[21]Killock D.Haematological cancer:Resiquimod-a topical CTCLtherapy[J].Nat Rev Clin Oncol,2015,126:1452-1461.
[22]Emmilia H,Lev P.Phototherapy of Mycosis Fungoides[J].Dermatol Clin,2015,33:697-702.
[23]Olsen EA,Hodak E,Anderson T,et al.Guidelines for phototherapy of mycosis fungoides and Sézary syndrome:A consensus statement of the United States Cutaneous Lymphoma Consortium[J].J Am Acad Dermatol,2016,74:27-58.
[24]Koh MJ,Chong WS.Narrow-band ultraviolet B phototherapy for mycosis fungoides in children[J].Clin Exp Dermatol,2014,39:474-478.
[25]Hernandez Z,Penate Y,Hernandezmachín B,et al.Treatment of stage Ia and Ib mycosis fungoides with psoralen UVAmonotherapy:an observational study in tertiary hospitals in the Canary Islands[J].Int J Dermatol,2014,53:1417-1422.
[26]Pavlotsky F,Hodak E,Ben AD,et al.Role of bath psoralen plus ultraviolet A in early-stage mycosis fungoides[J].J Am Acad Dermatol,2014,71:536-541.
[27]闫岩,徐晨琛,王涛,等.局部甲氧沙林加紫外线A治疗难治性蕈样肉芽肿皮损的初步研究[J].中华肿瘤杂志,2015,37:859-862.
[28]Biskup E,Naym DG,Gniadecki R.Small-molecule inhibitors of Ataxia Telangiectasia and Rad3 related kinase(ATR)sensitize lymphoma cells to UVA radiation[J].JDermatol Sci,2016,84:239-247.
[29]Olek-Hrab K,Silny W,Dańczak-Pazdrowska A,et al.Ultraviolet A1 phototherapy for mycosis fungoides[J].Clin Exp Dermatol,2013,38:126-130.
[30]Aydogan K,Yazici S,Balaban AS,et al.Efficacy of lowdose ultraviolet a-1 phototherapy for parapsoriasis/early-stage mycosis fungoides[J].Photochem Photobiol,2014,91:873-877.
[31]Mofty ME,Ramadan S,Fawzy MM,et al.Broad band UVA:a possible reliable alternative to PUVA in the treatment of early-stage mycosis fungoides[J].Photodermatol Photoimmunol Photomed,2012,28:274-277.
[32]Deaver D,Cauthen A,Cohen G,et al.Excimer laser in the treatment of mycosis fungoides[J].J Am Acad Dermatol,2014,70:1058-1060.
[33]Xu CC,Zhang T,Wang T,et al.Palliative Local Radiotherapy in the Treatment of Tumor-stage Cutaneous T-cell Lymphoma/Mycosis Fungoides[J].Chin Med Sci J,2014,29:33-37.
[34]Bakar O,Sahin S,Cetinozman F,et al.Tumor-stage mycosis fungoides of the vulva successfully treated with local low-dose radiotherapy[J].Dermatol Ther,2015,28:36-39.
[35]Jawed SI,Myskowski PL,Horwitz S,et al.Primary cutaneous T-cell lymphoma(mycosis fungoides and Sezary syndrome)Part II.Prognosis,management,and future directions[J].J Am Acad Dermatol,2014,70:223,e1-e17.
[36]Duvic M,Donato M,Dabaja B,et al.Total skin electron beam and non-myeloablative allogeneic hematopoietic stemcell transplantation in advanced mycosis fungoides and Sezary syndrome[J].J Clin Oncol,2010,28:2365-2372.
[37]Wagner AE,Wada D,Bowen G,et al.Mycosis fungoides:the addition of concurrent and adjuvant interferon to total skin electron beam therapy[J].Br J Dermatol,2013,169:715-718.
[38]Tandberg DJ,Craciunescu O,Kelsey CR.Radiation Therapy for Cutaneous T-Cell Lymphomas[J].Dermatol Clin,2015,33:703-713.
[39]Xue J,Liu C,Liu Y.Photodynamic therapy as an alternative treatment for relapsed or refractory mycosis fungoides:a systemic review[J].Photodiagnosis Photodyn Ther,2017,17:87-91.
[40]Kabata Y,Shimomura Y,Matsuo Y,et al.Photodynamic therapy with intradermal application of 5-aminolevulinic acid successfully improved tumor lesions of mycosis fungoides[J].Int J Dermatol,2017,56:e81-e82.
[41]Ariel H,Cristian ND,Claudia N,et al.Topical photodynamic therapy with 5-aminolevulinate for the treatment of tumor-stage mycosis fungoides:a case report[J].Int J Dermatol,2013,52:1535-1537.
[42]Rivetti N,Cananzi R,Borroni RG,et al.Effectiveness of photodynamic therapy in refractory plaque-stage mycosis fungoides associated with Bowen's disease[J].Dermatol Ther,2017,30:e12474.
[2]罗毅鑫,刘洁.皮肤T细胞淋巴瘤靶向治疗的研究进展[J].临床皮肤科杂志,2016,45:814-817.
[3]Nguyen CV,Bohjanen KA.Skin-Directed Therapies in Cutaneous T-Cell Lymphoma[J].Dermatol Clin,2015,33:683-696.
[4]Zackheim HS.Treatment of patch-stage mycosis fungoides with topical corticosteroids[J].Dermatol Ther,2003,16:283-287.
[5]Liu DY,Shaath T,Rajpara AN,et al.Safe and Efficacious Use of Intralesional Steroids for the Treatment of Focally Resistant Mycosis Fungoides[J].J Drugs Dermatol,2015,14:466-470.
[6]Lessin SR,Duvic M,Guitart J,et al.Topical chemotherapy in cutaneous T-cell lymphoma:positive results of a randomized,controlled,multicenter trial testing the efficacy and safety of a novel mechlorethamine,0.02%,gel in mycosis fungoides[J].JAMA Dermatol,2013,149:1-8.
[7]Benjamin CA,Markel K,Tawa MC.Optimizing Care and Compliance for the Treatment of Mycosis Fungoides Cutaneous T-Cell Lymphoma With Mechlorethamine Gel[J].Clin J Oncol Nurs,2015,19:E131-E139.
[8]Lindahl LM,Fenger-Gron M,Iversen L.Topical nitrogen mustard therapy in patients with mycosis fungoides or parapsoriasis[J].J Eur Acad Dermatol Venereol,2013,27:163-168.
[9]单百卉,李雪,郑玉洁,等.口服阿维A联合氮芥外用治疗老年蕈样肉芽肿1例[J].中国老年学,2013,33:1155-1156.
[10]Lindahl LM,Fengergrn M,Iversen L.Secondary cancers,comorbidities and mortality associated with nitrogen mustard therapy in patients with mycosis fungoides:a 30-year populationbased cohort study[J].Br J Dermatol,2014,170:699-704.
[11]Apisarnthanarax N,Wood GS,Stevens SR,et al.Phase Iclinical trial of O6-benzylguanine and topical carmustine in the treatment of cutaneous T-cell lymphoma,mycosis fungoides type[J].Arch Dermatol,2012,148:613-620.
[12]Macarthur KM,Jariwala N,Kim EJ,et al.Topical Carmustine as Monotherapy or as Multimodality Therapy for Folliculotropic Mycosis Fungoides[J].Acta Derm Venereol,2017,97:373-374.
[13]Heisig M,Maj J,Szepietowski JC,et al.Durable remission of folliculotropic mycosis fungoides achieved with a combined topical treatment with cytarabine and carmustine[J].Dermatol Ther,2015,29:15-18.
[14]Apisarnthanarax N,Talpur R,Ward S,et al.Tazarotene0.1% gel for refractory mycosis fungoides lesions:an open-label pilot study[J].J Am Acad Dermatol,2004,50:600-607.
[15]Besner MC,Roberge D,Turchin I,et al.Tazarotene 0.1% Cream as Monotherapy for Early-Stage Cutaneous T-Cell Lymphoma[J].J Cutan Med Surg,2016,20:244-248.
[16]Coors EA,Von d DP.Treatment of 2 patients with mycosis fungoides with alitretinoin[J].J Am Acad Dermatol,2012,67:e265-e267.
[17]Miernik B,Schmidt V,Technau-Hafsi K,et al.Alitretinoin in the treatment of palmoplantar mycosis fungoides:a new and promising therapeutic approach[J].Clin Exp Dermatol,2014,40:445-447.
[18]Bassiri-Tehrani S,David E.Treatment of cutaneous T-cell lymphoma with alitretinoin gel[J].Int J Dermatol,2002,41:104-106.
[19]Gordon MC,Sluzevich JC,Jambusariapahlajani A.Clearance of folliculotropic and tumor mycosis fungoides with topical 5%imiquimod[J].JAAD Case Rep,2015,1:348-350.
[20]Rook AH,Gelfand JC,Wysocka M,et al.Topical resiquimod can induce disease regression and enhance T-cell effector functions in cutaneous T-cell lymphoma[J].Blood,2015,126:1452.
[21]Killock D.Haematological cancer:Resiquimod-a topical CTCLtherapy[J].Nat Rev Clin Oncol,2015,126:1452-1461.
[22]Emmilia H,Lev P.Phototherapy of Mycosis Fungoides[J].Dermatol Clin,2015,33:697-702.
[23]Olsen EA,Hodak E,Anderson T,et al.Guidelines for phototherapy of mycosis fungoides and Sézary syndrome:A consensus statement of the United States Cutaneous Lymphoma Consortium[J].J Am Acad Dermatol,2016,74:27-58.
[24]Koh MJ,Chong WS.Narrow-band ultraviolet B phototherapy for mycosis fungoides in children[J].Clin Exp Dermatol,2014,39:474-478.
[25]Hernandez Z,Penate Y,Hernandezmachín B,et al.Treatment of stage Ia and Ib mycosis fungoides with psoralen UVAmonotherapy:an observational study in tertiary hospitals in the Canary Islands[J].Int J Dermatol,2014,53:1417-1422.
[26]Pavlotsky F,Hodak E,Ben AD,et al.Role of bath psoralen plus ultraviolet A in early-stage mycosis fungoides[J].J Am Acad Dermatol,2014,71:536-541.
[27]闫岩,徐晨琛,王涛,等.局部甲氧沙林加紫外线A治疗难治性蕈样肉芽肿皮损的初步研究[J].中华肿瘤杂志,2015,37:859-862.
[28]Biskup E,Naym DG,Gniadecki R.Small-molecule inhibitors of Ataxia Telangiectasia and Rad3 related kinase(ATR)sensitize lymphoma cells to UVA radiation[J].JDermatol Sci,2016,84:239-247.
[29]Olek-Hrab K,Silny W,Dańczak-Pazdrowska A,et al.Ultraviolet A1 phototherapy for mycosis fungoides[J].Clin Exp Dermatol,2013,38:126-130.
[30]Aydogan K,Yazici S,Balaban AS,et al.Efficacy of lowdose ultraviolet a-1 phototherapy for parapsoriasis/early-stage mycosis fungoides[J].Photochem Photobiol,2014,91:873-877.
[31]Mofty ME,Ramadan S,Fawzy MM,et al.Broad band UVA:a possible reliable alternative to PUVA in the treatment of early-stage mycosis fungoides[J].Photodermatol Photoimmunol Photomed,2012,28:274-277.
[32]Deaver D,Cauthen A,Cohen G,et al.Excimer laser in the treatment of mycosis fungoides[J].J Am Acad Dermatol,2014,70:1058-1060.
[33]Xu CC,Zhang T,Wang T,et al.Palliative Local Radiotherapy in the Treatment of Tumor-stage Cutaneous T-cell Lymphoma/Mycosis Fungoides[J].Chin Med Sci J,2014,29:33-37.
[34]Bakar O,Sahin S,Cetinozman F,et al.Tumor-stage mycosis fungoides of the vulva successfully treated with local low-dose radiotherapy[J].Dermatol Ther,2015,28:36-39.
[35]Jawed SI,Myskowski PL,Horwitz S,et al.Primary cutaneous T-cell lymphoma(mycosis fungoides and Sezary syndrome)Part II.Prognosis,management,and future directions[J].J Am Acad Dermatol,2014,70:223,e1-e17.
[36]Duvic M,Donato M,Dabaja B,et al.Total skin electron beam and non-myeloablative allogeneic hematopoietic stemcell transplantation in advanced mycosis fungoides and Sezary syndrome[J].J Clin Oncol,2010,28:2365-2372.
[37]Wagner AE,Wada D,Bowen G,et al.Mycosis fungoides:the addition of concurrent and adjuvant interferon to total skin electron beam therapy[J].Br J Dermatol,2013,169:715-718.
[38]Tandberg DJ,Craciunescu O,Kelsey CR.Radiation Therapy for Cutaneous T-Cell Lymphomas[J].Dermatol Clin,2015,33:703-713.
[39]Xue J,Liu C,Liu Y.Photodynamic therapy as an alternative treatment for relapsed or refractory mycosis fungoides:a systemic review[J].Photodiagnosis Photodyn Ther,2017,17:87-91.
[40]Kabata Y,Shimomura Y,Matsuo Y,et al.Photodynamic therapy with intradermal application of 5-aminolevulinic acid successfully improved tumor lesions of mycosis fungoides[J].Int J Dermatol,2017,56:e81-e82.
[41]Ariel H,Cristian ND,Claudia N,et al.Topical photodynamic therapy with 5-aminolevulinate for the treatment of tumor-stage mycosis fungoides:a case report[J].Int J Dermatol,2013,52:1535-1537.
[42]Rivetti N,Cananzi R,Borroni RG,et al.Effectiveness of photodynamic therapy in refractory plaque-stage mycosis fungoides associated with Bowen's disease[J].Dermatol Ther,2017,30:e12474.