Narasimhan Kailash, Kucuk Omer, Lin Ho-Sheng, Heilbrun Lance K, Carron Michael, Venkatramanamoorthy Raghu, Mathog Robert
Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Michigan.
Skull Base. 2009 Jul;19(4):255-62. doi: 10.1055/s-0028-1115321.
Report the experience of the Karmanos Cancer Institute with sinonasal mucosal melanoma (SNMM) in patients diagnosed between 1995 and 2007.
Eighteen patients, ages 31 to 85 (mean, 67), whose most common presenting symptoms included epistaxis and facial pressure. Most common anatomic locations were the maxillary sinus and nasal cavity. Seventy-two percent presented with tumors extending to the skull base, frontal sinus, orbit, or cranium. Tumor size ranged from 0.3 cm to 5.3 cm. Most common surgical procedure was medial maxillectomy (12 patients). Eight patients received chemotherapy, ten received radiotherapy and six received both. One third of patients received interferon-alpha. Median recurrence-free survival (RFS) was 14.4 months, with a 1-year RFS rate of 55%. Median overall survival (OS) was 19.3 months with a 1-year OS rate of 60% and a 2-year OS rate of 42%. The 5-year OS rate was 34%.
SNMM remains a disease that has eluded breakthroughs in treatment. Patients are typically treated with wide local resection; however unique to our institution was the frequent use of interferon and chemoradiation. Further research in adjuvant therapies will be necessary to improve outcomes.
报告卡曼诺斯癌症研究所1995年至2007年间诊断的鼻窦黏膜黑色素瘤（SNMM）患者的治疗经验。
18例患者，年龄31至85岁（平均67岁），最常见的症状包括鼻出血和面部压迫感。最常见的解剖部位是上颌窦和鼻腔。72%的患者肿瘤已扩展至颅底、额窦、眼眶或颅骨。肿瘤大小从0.3厘米至5.3厘米不等。最常见的手术方式是上颌骨内侧切除术（12例患者）。8例患者接受了化疗，10例接受了放疗，6例同时接受了放化疗。三分之一的患者接受了α干扰素治疗。无复发生存期（RFS）的中位数为14.4个月，1年RFS率为55%。总生存期（OS）的中位数为19.3个月，1年OS率为60%，2年OS率为42%。5年OS率为34%。
SNMM仍然是一种尚未在治疗上取得突破的疾病。患者通常接受广泛的局部切除治疗；然而，在我们机构独特的是频繁使用干扰素和放化疗。有必要对辅助治疗进行进一步研究以改善治疗效果。
