Abstract
Objective. The authors interest was focused on interferon impact on dopamine status and on the relation between negative emotional state and dopamine in melanoma patients. Methods. 60 patients diagnosed with malignant melanoma in 1st or 2nd clinical stage were included in the first 56 days after surgical removal of the tumor in an observational prospective study. The patients were divided in 2 groups: group A that included 30 cases treated with 10MU interferon alpha2b/mp three times a week for one year and group B that included 30 cases with no adjuvant treatment. Urinary dopamine (ELISA) was evaluated before treatment with interferon alpha2b, after 1, 6, 12 months of treatment and after 6 months from the end of the treatment. Neuropsychiatric disorders were grouped according to their frequency in melanoma patients. Results. Neuropsychiatric disorders associated with the treatment with interferon were: irritability, asthenia and fatigability, sleep disorders, anxiety, cognitive disorders, somatic symptoms. The treatment with interferon altered dopamine metabolism. Dopamine returned to the pretherapeutical values at six months after interferon was stopped. Patients with low levels of urinary dopamine had a high, statistically significant risk of developing depression during interferon treatment (OR=2.647, IC=2.186-3.014, p=0.0216). Conclusions. Low dopamine might have a major role in the development of depression secondary to interferon treatment.
Highlights
Radical surgery with safety margins, histologically confirmed, offers the best chance of curing early stages of malignant melanoma
Neuropsychiatric effects of interferon were evaluated in two homogenous groups for biological profile and demographical characteristics: 30 patients with melanoma treated with interferon alpha2b and 30 patients with melanoma without adjuvant treatment
The systemic therapy with interferon alpha 2b (IFN) in melanoma patients was associated with neuropsychiatric disorders, evaluated as follows: 1) very frequent: asthenia, fatigue, irritability, sleep disorders; 2) frequent: fear, lack of concentration, indecisiveness, irritative urinary symptoms; 3) less frequent: memory disturbance, muscle or joint pain, gastrointestinal symptoms
Summary
Radical surgery with safety margins, histologically confirmed, offers the best chance of curing early stages of malignant melanoma. Patients with 2A, 2B and 3B stages of melanoma according AJCC (American Joint Committee on Cancer), with high risk of recurrence, receive adjuvant systemic therapy. Multiple studies [1,2,3,4,5,6] evaluated the role of adjuvant therapy with interferon alpha 2b (IFN) in malignant melanoma. Most patients who received IFN presented liver, hematologic, neuropsychiatric and constitutional toxicity. The frequency of neuropsychiatric disorders was influenced by the administration of IFN, dose and time of administration, mental status of patients. A variety of neuropsychiatric disorders associated with
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