Merimsky O, Reider-Groswasser I, Inbar M, Kovner F, Chaitchik S
Department of Oncology, Ichilov Hospital, Tel-Aviv Sourasky Medical Center, Israel.
Melanoma Res. 1992 Dec;2(5-6):385-91.
Thirty patients with malignant melanoma and cerebral metastases confirmed by CT were studied. Metastases were classified according to their size: < or = 1 cm (group A), 1.1-4 cm (group B), and > 4 cm (group C), in order to assess the clinical course of the disease and predict the response to treatment with fotemustine. Group B lesions were the most common, independent of the site of the primary tumour, except for patients with rectal melanoma. Group C metastases were least common and were usually solitary. Asymptomatic patients usually had group A metastases, whereas those with non-specific complaints, hemisyndrome or neurobehavioural changes usually had group B metastases. The time from diagnosis of the primary tumour to discovery of disease in the CNS was significantly longer for those who had group A lesions, compared with those who had groups B or C lesions (P < 0.0001). Solitary lesions usually belonged to groups B or C, whereas multiple lesions belonged mainly to groups A or B. All the responders to fotemustine has mainly cortical, group A or group B lesions. Patients with group C lesions or leptomeningeal spread did not respond to fotemustine. Our findings suggest an association between the size of the cerebral metastatic lesion from malignant melanoma and clinical parameters characteristic of tumour behaviour.
对30例经CT确诊为恶性黑色素瘤并伴有脑转移的患者进行了研究。根据转移灶大小对转移情况进行分类：≤1 cm（A组）、1.1 - 4 cm（B组）和＞4 cm（C组），以评估疾病的临床进程并预测福莫司汀的治疗反应。B组病灶最为常见，与原发性肿瘤部位无关，但直肠黑色素瘤患者除外。C组转移最不常见，通常为单发。无症状患者通常有A组转移灶，而有非特异性主诉、偏侧综合征或神经行为改变的患者通常有B组转移灶。与有B组或C组病灶的患者相比，有A组病灶的患者从原发性肿瘤诊断到中枢神经系统发现疾病的时间显著更长（P＜0.0001）。单发病灶通常属于B组或C组，而多发病灶主要属于A组或B组。所有对福莫司汀有反应的患者主要有皮质、A组或B组病灶。有C组病灶或软脑膜播散的患者对福莫司汀无反应。我们的研究结果表明，恶性黑色素瘤脑转移病灶的大小与肿瘤行为的临床参数之间存在关联。
