Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer. 2014 May 1;120(9):1361-8. doi: 10.1002/cncr.28415. Epub 2013 Oct 18.
In the current study, the authors sought to evaluate outcomes, specifically with respect to adjuvant radiotherapy (RT), for patients with desmoplastic melanoma.
The records of 130 consecutive patients who presented between 1985 and 2009 with nonmetastatic desmoplastic melanoma and were treated curatively with either surgery alone (59 patients; 45%) or surgery and postoperative RT (71 patients; 55%) were retrospectively reviewed. Ages ranged from 21 years to 97 years (median age, 66 years). The location of the primary tumor was in the head and neck region in 62% of patients. Only 5 patients (4%) had lymph node involvement at the time of presentation.
The median follow-up was 6.6 years (range, 11 months-24 years). Overall survival rates at 5 years and 10 years were 69% and 53%, respectively. Disease-specific survival rates were 84% and 80%, respectively, at 5 years and 10 years. The actuarial rate of local recurrence was 17% at 5 years and beyond. Of the patients who underwent surgery without receiving postoperative RT, 14 (24%) experienced local recurrence. Of the 71 patients treated with surgery and postoperative RT, 5 (7%) experienced local recurrence. In a Cox multivariate regression model, improved local control was significantly associated with the receipt of postoperative RT (P= .009).
Surgery followed by postoperative RT appears to provide superior local control compared with surgery alone for patients with desmoplastic melanoma.
在目前的研究中，作者旨在评估患者的预后，尤其是辅助放疗（RT）的疗效。
回顾性分析了 1985 年至 2009 年间连续 130 例非转移性促结缔组织增生性黑色素瘤患者的病历资料，这些患者接受了根治性手术治疗，其中 59 例（45%）患者接受了单纯手术治疗，71 例（55%）患者接受了手术联合术后 RT 治疗。患者年龄 21~97 岁，中位年龄 66 岁。原发肿瘤位于头颈部的患者占 62%。仅 5 例（4%）患者就诊时存在淋巴结转移。
中位随访时间为 6.6 年（11 个月~24 年）。5 年和 10 年总生存率分别为 69%和 53%，疾病特异性生存率分别为 84%和 80%。5 年及以后的局部复发率为 17%。未接受术后 RT 的患者中，14 例（24%）出现局部复发，接受手术联合术后 RT 的患者中，5 例（7%）出现局部复发。在 Cox 多因素回归模型中，术后 RT 与局部控制的改善显著相关（P=0.009）。
与单纯手术相比，手术联合术后 RT 可显著提高促结缔组织增生性黑色素瘤患者的局部控制率。
