Assuntos
Dermatite Atópica/complicações , Eczema/complicações , Prurido/etiologia , Psoríase/complicações , Escabiose/complicações , Urticária/complicações , Distribuição de Qui-Quadrado , Dermatite Atópica/diagnóstico , Diagnóstico Diferencial , Eczema/diagnóstico , Humanos , Valor Preditivo dos Testes , Prurido/diagnóstico , Psoríase/diagnóstico , Fatores de Risco , Escabiose/diagnóstico , Inquéritos e Questionários , Urticária/diagnósticoAssuntos
Anticorpos Anti-Idiotípicos/imunologia , Antígenos de Protozoários/imunologia , Autoanticorpos/imunologia , Doenças Autoimunes/imunologia , Epiderme/imunologia , Imunoglobulina A/imunologia , Dermatopatias Vesiculobolhosas/imunologia , Anticorpos Anti-Idiotípicos/análise , Doenças Autoimunes/diagnóstico , Biópsia , Pré-Escolar , Diagnóstico Diferencial , Epiderme/patologia , Técnica Direta de Fluorescência para Anticorpo , Seguimentos , Humanos , Dermatopatias Vesiculobolhosas/diagnósticoAssuntos
Eosinofilia/diagnóstico , Proteinúria/diagnóstico , Cogumelos Shiitake/imunologia , Dermatopatias/diagnóstico , Adulto , Biópsia , Diagnóstico Diferencial , Eosinofilia/tratamento farmacológico , Eosinofilia/embriologia , Glucocorticoides/uso terapêutico , Humanos , Testes de Função Hepática , Masculino , Prednisona/uso terapêutico , Proteinúria/tratamento farmacológico , Proteinúria/imunologia , Dermatopatias/tratamento farmacológico , Dermatopatias/embriologia , SíndromeRESUMO
BACKGROUND: Metastatic melanoma is one of the most aggressive tumours, with a median survival that does not exceed 12 months. None of the cytotoxic first-line therapies have shown survival benefit in randomised clinical trials. OBJECTIVE: To describe clinical benefit of second-line cytotoxic chemotherapy in the second line of treatment for metastatic melanoma. METHODS: In a retrospective study, we analyse the outcome of patients with metastatic melanoma who had received two lines or more of cytotoxic treatments in four French dermato-oncology departments between 1999 and 2009. RESULTS: We describe the outcomes for 109 patients. Most of these patients received dacarbazine for the first line of chemotherapy and fotemustine for the second line of chemotherapy (67.0 and 64.2%, respectively). A clinical benefit was observed in 24.1% of the patients and overall survival was 4.1 months after the second-line treatment. At least 23.8% of patients suffered from grade 3 or 4 toxicities. The presence of more than two sites of metastasis and an M1c staging according to the AJCC classification represented negative predictive factors of clinical benefit. CONCLUSION: This study shows the modest benefit of a second line of cytotoxic chemotherapy in a nonselected population. If eligible, these patients should be proposed for ongoing clinical trials or for targeted therapies.