双侧颈部皮肤转移黑色素瘤患者术后放疗的作用：批判性评估。

Role of postoperative irradiation for patients with bilateral cervical nodal metastases from cutaneous melanoma: a critical assessment.

机构信息

Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

出版信息

Head Neck. 2010 Jun;32(6):708-13. doi: 10.1002/hed.21238.

DOI:10.1002/hed.21238

PMID:19787786

Abstract

BACKGROUND

The aim of this study was to evaluate the role of regional nodal radiation therapy (RT) for patients with bilateral cervical nodal metastases from melanoma.

METHODS

Between 1998 and 2008, 16 patients with bilateral cervical metastases without distant metastases were treated with postoperative RT (30 Gy in 5 fractions delivered twice weekly).

RESULTS

Median follow-up was 5 months (range, 1-34 months). Median survival was 9 months (95% confidence interval [CI], 0-23 months). Overall survival was 68%, 50%, and 27% at 6, 12, and 24 months, respectively. Regional nodal control was 74% and 64% at 6 and 12 months, respectively. Rates of development of distant metastasis were 60%, 70%, and 90% at 6, 12, and 18 months, respectively. The actuarial rate of RT-related complications was 49% at 12 months.

CONCLUSION

The limited life expectancy of patients observed with this disease combined with the high rate of RT-related complications argue against the routine use of adjuvant RT for regional nodal disease in this setting.

摘要

背景

本研究旨在评估双侧颈部淋巴结转移的黑色素瘤患者接受区域淋巴结放疗（RT）的作用。

方法

1998 年至 2008 年间，16 例无远处转移的双侧颈部转移患者接受了术后 RT（30Gy，每周两次，分 5 次给予）。

结果

中位随访时间为 5 个月（范围，1-34 个月）。中位生存期为 9 个月（95%置信区间[CI]，0-23 个月）。6、12 和 24 个月时的总生存率分别为 68%、50%和 27%。6 个月和 12 个月时区域淋巴结控制率分别为 74%和 64%。远处转移的发展率分别为 6 个月、12 个月和 18 个月时的 60%、70%和 90%。12 个月时 RT 相关并发症的累积发生率为 49%。