Wagner Marcus, Morris Christopher G, Werning John W, Mendenhall William M
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida 32610-0385, USA.
Am J Clin Oncol. 2008 Feb;31(1):43-8. doi: 10.1097/COC.0b013e318134ee88.
Outcomes after radiotherapy for head and neck mucosal melanoma (MMHN).
From 1974 to 2005, 17 patients with primary MMHN were treated with radiotherapy. Primary sites included nasal cavity, paranasal sinuses, and oral cavity or oropharynx. Thirteen patients received surgery and postoperative radiotherapy; 4 received definitive radiotherapy.
Local control was 79% at 1 and 5 years for 13 of 13 patients treated with surgery and postoperative radiotherapy compared with 1 of 4 patients treated with definitive radiotherapy. Three patients recurred in the neck; 13 patients developed distant metastases. Disease-free survival was 23% at 1 year and 18% at 5 years. Absolute and cause-specific survivals were identical (53% and 28% at 1 and 5 years).
Locoregional control is relatively high after surgery and adjuvant radiotherapy, but most patients recur in distant sites; approximately one fourth of patients are cured at 5 years. Patients with unresectable tumor may be controlled with definitive radiotherapy.
头颈部黏膜黑色素瘤(MMHN)放疗后的结局。
1974年至2005年,17例原发性MMHN患者接受了放疗。原发部位包括鼻腔、鼻窦、口腔或口咽。13例患者接受了手术及术后放疗;4例接受了根治性放疗。
13例接受手术及术后放疗的患者中,1年和5年时的局部控制率为79%,而4例接受根治性放疗的患者中只有1例达到此效果。3例患者颈部复发;13例患者发生远处转移。无病生存率1年时为23%,5年时为18%。绝对生存率和病因特异性生存率相同(1年和5年时分别为53%和28%)。
手术及辅助放疗后局部区域控制率相对较高,但大多数患者会出现远处复发;约四分之一的患者在5年时治愈。无法切除肿瘤的患者可通过根治性放疗得到控制。