THE EXPERIMENTAL LOCAL THERAPY OF CUTANEOUS METASTASES OF MALIGNANT MELANOBLASTOMAS WITH COW POX VACCINE OR COLCEMLD (DEMECOLCINE OE OMAINE)
THE EXPERIMENTAL LOCAL THERAPY OF CUTANEOUS METASTASES OF MALIGNANT MELANOBLASTOMAS WITH COW POX VACCINE OR COLCEMLD (DEMECOLCINE OE OMAINE)
复制标题
使用牛痘疫苗或 COLCEMLD (Demecolcine OE Omaine) 治疗恶性黑色素瘤皮肤转移的实验性局部治疗
DOI：
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发表时间：
1961
期刊：
影响因子：
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通讯作者：
G. Milton
中科院分区：
文献类型：
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作者：
J. C. Belisario;G. Milton
1960 年 4 月，我们中的一个人（J.C.B.）收到一封来自奥莫兰州克利夫兰的 Euth Eauschkolb 博士的信，信中描述了一名 29 岁白人女性的案例，她说她在高中时左脚底有一颗棕色痣。大约三年前，左大腿膝盖以上出现了一个棕色肿块。它被广泛切除并发现是恶性的，因此切除了左侧腹股沟淋巴结。此时，她的左大腿前侧正中出现了一个拳头大小的紫色肿瘤，周围有约50个肉色结节。左侧腹股沟处可触及肿块，左侧乳房和腋窝处可触及肿块。她被 K. H. Burdick 医生（他也于 1961 年 1 月写信给 J.C.B.）入住克利夫兰诊所，患有腹股沟、颈部和肺部转移，以及躯干和头部皮肤的多处转移。 Burdick博士（1961）首先给最大的皮肤肿瘤注射活疫苗病毒，发现患者表现出加速反应。然后，他将用生理盐水稀释的天花疫苗注射到皮肤中的各个转移结节中。最初，他开始使用 0-2 c.c. 稀释的三瓶疫苗。生理盐水。剂量逐渐增加至总共五瓶。随着她的改善，服药间隔时间延长至长达一个月。 。注射后约四小时，患者会出现以恶心、呕吐和发烧为特征的毒性反应，持续四个小时。较小的结节在四个星期内消失，较大的结节以及任何新的病变均被再次注射。 。 : ,, 除了大腿上的大转移瘤尺寸明显缩小外，所有皮肤转移瘤都消失了。脚底的主要部位受到的影响很小。治疗并没有阻止进一步转移的发生。 …… ;患者还服用了 25 毫克。氮芥和 15 毫克。硫替派在早期进入股动脉。有趣的是，皮肤转移瘤对这种动脉内治疗没有反应，但对注射活痘苗病毒有反应。 。 。 .. 在最近的一封信中（1961 年 8 月），Burdick 博士指出：“似乎较大的皮肤损伤效果不如小损伤。任何直径超过 1 厘米的皮肤似乎对疫苗的效果都很差。”他还观察到“似乎对疫苗病毒产生最佳反应的人是那些对注射的疫苗病毒也产生毒性反应的人”。此外，他还指出，从他和他的同事对仓鼠肿瘤病变和一些恶性黑色素母细胞瘤进行的少量组织学研究来看，似乎存在非常明确的由牛痘病毒引起的细胞坏死。
IN April, 1960, one of us (J.C.B.) received a letter from Dr. Euth Eauschkolb from Cleveland, OMo, in wMcli slie described the case of a 29-year-old white woman who stated that she had a brown mole on the sole of her left foot when she was at high school. About three years previously a brown mass appeared on the left thigh above the knee. This was widely excised and found to be malignant, so the left inguinal nodes were removed. At this time she had a fist-sized purple tumour in the middle of the anterior aspect of the left thigh, surrounded by about 50 flesh-coloured nodules. There were palpable masses in the left groin and a mass in the left breast and axilla. She was admitted to the Cleveland Clinic under Dr. K. H. Burdick (who also wrote to J.C.B. in January, 1961) with inguinal, cervical and pulmonary metastases as well as a number of metastases to the skin of the trunk and head. Dr. Burdick (1961) first injected the largest skin tumour with live vaccina virus and found the patient showed an accelerated reaction. He then proceeded to inject smallpox vaccine diluted in normal saline into individual metastic nodules in the skin. Initially he commenced with three vials of vaccine diluted with 0-2 c.c. of normal saline. The dosage was gradually worked up to a total of five vials. As she improved the time between doses was increased to as long as a month. . Some four hours after the injection the patient would have a toxic reaction characterized by nausea, vomitiag and fever which lasted four hours. The smaller nodules disappeared in four weeks, and the larger ones were injected again, also any new lesions. . : ,, All cutaneous metastases disappeared except the large one in the thigh, which regressed considerably in size. The primary site on the sole of the foot was very little affected. The treatment did not prevent the occurrence of further metastases. .. . ; The patient was also given 25 mg. of nitrogen mustard and 15 mg. of thio-tepa into the femoral artery in the early stages. It is interesting to note that the skin metastases did not respond to this intra-arterial therapy, but did respond to the injections of live vaccinia virus. . . .. In a recent letter (August, 1961) Dr. Burdick states : " I t seems that the larger cutaneous lesions do not do as well as do the small lesions. Anything over 1 cm. in diameter seems to do rather poorly with the vaccina." He also makes the observation " It would seem that the individuals who obtaia the best response from the vaccina virus are those who also obtain a toxic type of reaction to the injected vaccina virus ". In addition he states that from the few histological studies he and his associates have made on tumour lesions and a number of malignant melanoblastomas in the hamster, it would seem there is a very definite cell necrosis caused by the vaccinia virus.