Melanoma and Skin Cancer Unit, Veneto Oncology Institute, IRCCS, Padua, Italy. mgaliz @ tiscali.it
Dermatology. 2013;226 Suppl 1:22-7. doi: 10.1159/000348870. Epub 2013 May 29.
Melanoma incidence and mortality rates are rising in Italy, indicating that more effective treatments are required both in the adjuvant and metastatic settings. We analyzed clinical practices in the adjuvant and metastatic settings by conducting a nationwide survey of clinicians responsible for managing melanoma treatment and follow-up in a representative sample of Italian hospitals. 95% of participating hospitals completed the panel of questions on adjuvant and metastatic treatment, making it likely that these results give a realistic picture of treatment and follow-up of melanoma patients in Italy. In low-volume hospitals (<25 new melanoma diagnoses yearly) adjuvant therapy was significantly more used than in large-volume hospitals for patients in stage III and IV (82 versus 66% and 56 versus 30%, respectively), and only 11% of patients were enrolled in clinical trials. In the metastatic setting dacarbazine was the preferred first-line treatment (32%) followed by polychemotherapy (23%); 12% of patients were enrolled in clinical trials and less than 10% received interleukin-2, usually subcutaneously. The information provided by this study was used by the Italian Melanoma Intergroup to improve the quality of care and to redirect financial resources.
意大利的黑色素瘤发病率和死亡率正在上升，这表明在辅助治疗和转移性治疗方面都需要更有效的治疗方法。我们通过对负责管理黑色素瘤治疗和随访的临床医生进行全国性调查，分析了辅助治疗和转移性治疗方面的临床实践。95%的参与医院完成了关于辅助治疗和转移性治疗的小组问题，这使得这些结果很可能反映了意大利黑色素瘤患者的治疗和随访情况。在低容量医院（每年新诊断的黑色素瘤病例少于 25 例）中，III 期和 IV 期患者的辅助治疗明显比大容量医院更常用（分别为 82%和 66%，56%和 30%），且只有 11%的患者参加了临床试验。在转移性治疗中，达卡巴嗪是首选的一线治疗药物（32%），其次是联合化疗（23%）；12%的患者参加了临床试验，不到 10%的患者接受了白细胞介素-2 治疗，通常是皮下注射。意大利黑色素瘤研究组利用这项研究提供的信息来改善护理质量，并重新分配财政资源。
