摘要
目的 评价鼻腔黑色素瘤的治疗方法及疗效。方法 对 2 4例鼻腔黑色素瘤进行回顾性分析。临床分期中Ⅰ期 6例 ,Ⅱ期 6例 ,Ⅲ期 8例 ,Ⅳ期 4例。病理分型中巨细胞型 12例 ,小细胞型7例 ,上皮样细胞型 3例 ,梭形细胞型 2例。治疗方法中单纯手术治疗 12例 ,单纯放射治疗 2例 ,手术加放射治疗 7例 ,手术加化疗 2例 ,化疗加生物治疗 1例。生存分析采用Kaplan Meier法 ,组间比较采用Logrank检验 ,率的比较采用 χ2 检验。结果 6例首诊误诊 ,后经免疫组织化学确诊。治疗后总的3、5年生存率分别为 4 0 .9%、2 2 .7%。单纯手术组 5年生存率为 33.3% ,手术加放射治疗组 5年生存率为 16 .7% ,两者相比差异无显著性意义 (P =0 .70 8) ,两组局部复发率差异也无显著性意义 (P =0 .35 0 )。 5年局部复发率为 4 0 % ,5年远地转移率为 16 %。结论 免疫组织化学对黑色素瘤诊断和鉴别诊断有重要价值 ,手术不彻底是疗效不满意的主要原因 ,辅助放射治疗可能有助于提高局部控制率。
ObjectiveTo evaluate the clinical effect and treatment for malignant melanoma in the nasal cavity. MethodsTwenty-four patients suffering from malignant melanoma in the nasal cavity were retrospectively studied. There were 6 patients with stage I,6 stage Ⅱ,8 stage Ⅲ and 4 stage Ⅳ lesions. All were confirmed by histology: 12 giant-cell type,7 small-cell type,3 epithelial-cell type and 2 fusiform-cell type. The problem of misdiagnosis of 6 patients was finally solved by immunohistochemical methods. Twelve patients received surgery alone,2 radiotherapy alone,7 surgery plus radiotherapy,2 surgery plus chemotherapy and 1 chemotherapy plus biotherapy. Survival analysis was performed by Kaplan-Meier estimates and the comparisons between groups were performed by Log-rank test. Chi square test was used in the comparison of rates. ResultsThe overall 3-year and 5-year survival rates were 40.9% and 22.7%. The 5-year survival rates for patients who received surgery alone and those who received surgery plus radiotherapy were 33.3% and 16.7% respectively,with the difference insignificant (P=0.708). There was no significant difference in recurrence rate between the two groups (P= 0.350 ). The 5-year local recurrence and distant metastasis rates were 40% and 16%. ConclusionsImmunohistochemistry is important in the diagnosis and differential diagnosis of malignant melanoma. Incomplete surgery is the main reason for unsatisfactory effect. Adjuvant radiotherapy may improve the local control.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2004年第1期8-11,共4页
Chinese Journal of Radiation Oncology
