■霉菌病(MF)是一种皮肤淋巴瘤;大多数患者出现早期,皮肤限制的疾病,由皮肤科医生管理。
■本研究的目的是系统地回顾和评估早期局部治疗的证据(IA,IB,IIA)MF。
■我们通过MEDLINE进行了文献检索,Embase,WebofScience,和Cochrane数据库。分级建议评估,使用开发和评估(GRADE)标准来评估数据的确定性。
■两次搜索产生了1252个参考文献;26个符合纳入标准,并包括有关氮芥的文献,类维生素A,皮质类固醇,卡莫司汀,氟尿嘧啶,甲氨蝶呤-劳罗卡普兰,十六烷基磷酸胆碱,Peldesine,麦辛醇,局部用甲氨蝶呤与氧气流动辅助LP3载体,和瑞斯基莫德。大多数研究是单一干预,观测系列。氮芥,发表最多的报告,12%-82%的早期MF患者(总n>1000)达到完全缓解(CR)(低确定性证据)。在使用局部类维生素A治疗的10%-60%中实现了临床CR(低确定性证据)。两个中等规模的回顾性病例系列的局部类固醇有18%-63%的CR(低确定性证据)。只有单一研究可用于其他疗法。
■对于大多数感兴趣的结果,早期MF局部治疗的分级确定性较低.需要进一步的随机对照试验和纳入生活质量指标。
UNASSIGNED: Mycosis fungoides (MF) is a cutaneous lymphoma; most patients present with early, skin-limited disease and are managed by dermatologists.
UNASSIGNED: The purpose of this study was to systematically review and assess the evidence on topical treatments for early-stage (IA, IB, IIA) MF.
UNASSIGNED: We performed a literature search via MEDLINE, Embase, Web of Science, and Cochrane databases. Grading Recommendations Assessment, Development and Evaluation (GRADE) criteria were used to assess the certainty of the data.
UNASSIGNED: Two searches yielded 1252 references; 26 met the inclusion criteria and included literature on nitrogen mustard, retinoids, corticosteroids, carmustine, fluorouracil, methotrexate-laurocapram, hexadecylphosphocholine, peldesine, ingenol mebutate, topical methotrexate with oxygen flow-assisted LP3 carrier, and resiquimod. Most studies were single intervention, observational series. Nitrogen mustard, with the most published reports, was effective with 12%-82% early-stage MF patients (total n > 1000) achieving complete remission (CR) (low certainty evidence). Clinical CR was achieved among 10%-60% treated with topical retinoids (low certainty evidence). Two moderate-sized retrospective case series on topical steroids had 18%-63% CR (low certainty evidence). Only single studies were available for the other therapies.
UNASSIGNED: For most outcomes of interest, the GRADE certainty for topical therapies for early-stage MF was low. Further randomized controlled trials and inclusion of quality of life indicators are needed.