Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkunkwan University School of Medicine, Seoul, Korea.
Melanoma Res. 2011 Jun;21(3):223-7. doi: 10.1097/CMR.0b013e3283457743.
Malignant melanoma, a neoplastic disorder produced by malignant transformation of the melanocyte, is considered to be resistant to chemotherapy. Dacarbazine is one of the standard chemotherapeutic agents in Korea. This study is designed to analyze treatment outcome and delineate prognostic factors based on clinical parameters for patients with advanced malignant melanoma who had received dacarbazine-based chemotherapy. This is a multicenter, retrospective analysis of 95 patients with metastatic malignant melanoma who had received dacarbazine-based chemotherapy, from January 1997 to June 2010. After a median follow-up duration of 41 months (range, 2-191 months), median survival time from the start of treatment was 12.1 months [95% confidence interval (CI): 10.9-13.5]. The overall response rate was 26.3% (95% CI: 17.8-36.4). On univariate analysis, primary site [mucosa of head and neck, gastrointestinal (GI)/genitourinary tract > cutaneous+acral melanoma], metastases to liver, GI tract, and elevated lactate dehydrogenase adversely influenced on survival. At a multivariate level, independent poor prognostic factors were mucosal melanoma [P=0.001; hazard ratio (HR): 2.988; 95% CI: 1.534-5.821], metastasis to GI tract [P=0.040; HR: 2.108; 95% CI: 1.036-4.288], and elevated lactate dehydrogenase (P=0.047; HR: 1.695; 95% CI: 1.007-2.854). Dacarbazine-based chemotherapy seems to be a reasonable option in Asia where mucosal melanoma is more prevalent than in the West. The dacarbazine-based chemotherapy showed an overall response rate of 26.3% and an overall survival of 12.1 months without a significant difference in response rates between noncutaneous or cutnaeous melanoma.
恶性黑色素瘤是一种由黑色素细胞恶性转化引起的肿瘤性疾病，被认为对化疗有抗性。达卡巴嗪是韩国的一种标准化疗药物。本研究旨在分析接受达卡巴嗪为基础的化疗的晚期恶性黑色素瘤患者的治疗结果，并根据临床参数描绘预后因素。这是一项多中心、回顾性分析，纳入了 95 例自 1997 年 1 月至 2010 年 6 月期间接受达卡巴嗪为基础的化疗的转移性恶性黑色素瘤患者。中位随访时间为 41 个月（范围：2-191 个月），从治疗开始的中位生存时间为 12.1 个月[95%置信区间（CI）：10.9-13.5]。总体缓解率为 26.3%（95%CI：17.8-36.4）。单因素分析显示，原发部位[头颈部黏膜、胃肠道/泌尿生殖道>皮肤+肢端黑色素瘤]、肝、胃肠道和乳酸脱氢酶升高的转移对生存有不利影响。多因素分析显示，独立的预后不良因素为黏膜黑色素瘤[P=0.001；风险比（HR）：2.988；95%CI：1.534-5.821]、胃肠道转移[P=0.040；HR：2.108；95%CI：1.036-4.288]和乳酸脱氢酶升高（P=0.047；HR：1.695；95%CI：1.007-2.854）。在黏膜黑色素瘤比西方更为普遍的亚洲地区，达卡巴嗪为基础的化疗似乎是一种合理的选择。达卡巴嗪为基础的化疗总缓解率为 26.3%，总生存时间为 12.1 个月，非皮肤或皮肤黑色素瘤的缓解率无显著差异。
