Krengli Marco, Jereczek-Fossa Barbara Alicja, Kaanders Johannes H A M, Masini Laura, Beldì Debora, Orecchia Roberto
Department of Radiotherapy, Hospital Maggiore, University of Piemonte Orientale, Corso Mazzini, 18-28100 Novara, Italy.
Crit Rev Oncol Hematol. 2008 Feb;65(2):121-8. doi: 10.1016/j.critrevonc.2007.07.001. Epub 2007 Sep 5.
Mucosal melanoma of the head and neck is a rare, poor prognosis tumour with a high tendency to recur locally and regionally after surgical resection. A number of centres have used radiotherapy to sterilize positive and close margins after non-radical surgery or to treat inoperable cases. The present article discusses the literature data to analyze the possible indications for radiotherapy in terms of patient selection and treatment strategy. In the majority of the available retrospective series, postoperative radiotherapy improves the local control of mucosal melanomas, but its effect on survival has not yet been sufficiently investigated. Radiobiological studies show a high heterogeneity in behaviour of irradiated melanoma cells and the clinical implications of this will be illustrated. In the future, a better understanding of the radiosensitivity of this rare tumour and the availability of new technical modalities might allow for a more profitable incorporation of radiotherapy into a multidisciplinary strategy.
头颈部黏膜黑色素瘤是一种罕见的、预后较差的肿瘤，手术切除后局部和区域复发倾向较高。一些中心已采用放射治疗来消除非根治性手术后的阳性切缘和近切缘，或治疗无法手术的病例。本文讨论文献数据，从患者选择和治疗策略方面分析放射治疗的可能适应证。在大多数现有的回顾性系列研究中，术后放射治疗可改善黏膜黑色素瘤的局部控制，但对生存的影响尚未得到充分研究。放射生物学研究表明，受照射的黑色素瘤细胞行为具有高度异质性，并将说明其临床意义。未来，对这种罕见肿瘤放射敏感性的更好理解以及新技术模式的应用，可能会使放射治疗更有效地纳入多学科治疗策略。
