头颈部原发性黏膜黑色素瘤的快中子放射治疗
Fast neutron radiotherapy for primary mucosal melanomas of the head and neck.
作者信息
Liao Jay J, Parvathaneni Upendra, Laramore George E, Thompson John A, Bhatia Shailender, Futran Neal D, Bhrany Amit D, Hawes Stephen E, Ladra Matthew
机构信息
University of Washington, Department of Radiation Oncology, Seattle, Washington.
出版信息
Head Neck. 2014 Aug;36(8):1162-7. doi: 10.1002/hed.23428. Epub 2014 Jan 17.
BACKGROUND
Primary head and neck mucosal melanomas (HNMMs) are rare tumors managed with surgery and/or radiotherapy and associated with poor outcomes. Given their radioresistance, high linear energy transfer radiotherapy with neutrons may improve local control.
METHODS
We conducted a retrospective review of 14 patients with HNMM treated with neutrons at the University of Washington from 1990 to 2012. Five patients had T3 disease, 9 had T4 disease, 3 had regional nodal disease, and 4 had distant metastases at diagnosis. Primary sites were sinonasal (n=10), lip (n=2), and palate (n=2). Ten patients had initial surgical resection/debulking.
RESULTS
Nine patients had gross residual disease, 6 had complete response, and 3 had partial response. Local control was achieved in 79% until death or last follow-up, and 50% developed distant metastases. Kaplan-Meier 5-year local control was 66% and overall survival was 21%.
CONCLUSION
High rates of locoregional control were achieved with neutrons, despite the presence of gross disease. Survival was limited by early distant metastases.
背景
原发性头颈部黏膜黑色素瘤（HNMMs）是罕见肿瘤，采用手术和/或放疗治疗，预后较差。鉴于其放射抗性，中子高传能线密度放疗可能改善局部控制。
方法
我们对1990年至2012年在华盛顿大学接受中子治疗的14例HNMM患者进行了回顾性研究。5例患者诊断时为T3期疾病，9例为T4期疾病，3例有区域淋巴结疾病，4例有远处转移。原发部位为鼻窦（n = 10）、唇部（n = 2）和腭部（n = 2）。10例患者最初接受了手术切除/减瘤手术。
结果
9例患者有肉眼可见的残留病灶，6例完全缓解，3例部分缓解。至死亡或最后一次随访时，79%的患者实现了局部控制，50%的患者发生了远处转移。Kaplan-Meier法计算的5年局部控制率为66%，总生存率为21%。
结论
尽管存在肉眼可见的病灶，但中子放疗实现了较高的局部区域控制率。生存受早期远处转移的限制。
Zotero 插件