Marinova Lena, Yordanov Kaloyan, Sapundgiev Nikolay
Radiotherapy Department, Oncology Hospital, Medical University - Varna, Varna, Bulgaria.
Oto-rhyno-laryngology Department, University Hospital "Sveta Marina", Medical University - Varna, Varna, Bulgaria.
Rep Pract Oncol Radiother. 2010 Dec 21;16(1):40-3. doi: 10.1016/j.rpor.2010.11.004. eCollection 2010.
The place of adjuvant radiotherapy in the treatment of sinonasal melanoma.
Sinonasal mucosal melanoma is a rare disease with poor prognosis and requires a complex treatment. Elective neck dissection in patients with N0 and adjuvant radiotherapy has been a source of controversy. High late regional recurrence rates rise questions about elective irradiation of the neck nodes in patients with N0 stage disease.
We present our two years' follow up in a case of locally advanced sinonasal melanoma and literature review of the treatment options for mucosal melanoma.
In locally advanced sinonasal melanoma treated with surgical resection, postoperative radiotherapy and chemotherapy we had local tumor control. Two years later, a regional contralateral recurrence without distant metastasis occurred.
Literature data for frequent neck lymph nodes recurrences justify elective neck dissection. Postoperative elective neck radiotherapy for patients with locally advanced sinonasal melanoma and clinically N0 appears to decrease the rate of late regional recurrences.
辅助放疗在鼻窦黑色素瘤治疗中的地位。
鼻窦黏膜黑色素瘤是一种预后较差的罕见疾病，需要复杂的治疗。N0期患者的选择性颈部清扫术和辅助放疗一直存在争议。较高的晚期区域复发率引发了关于N0期疾病患者颈部淋巴结选择性照射的疑问。
我们报告了一例局部晚期鼻窦黑色素瘤的两年随访情况，并对黏膜黑色素瘤的治疗选择进行了文献综述。
在接受手术切除、术后放疗和化疗的局部晚期鼻窦黑色素瘤患者中，我们实现了局部肿瘤控制。两年后，出现了对侧区域复发，无远处转移。
文献数据显示颈部淋巴结频繁复发证明选择性颈部清扫是合理的。对于局部晚期鼻窦黑色素瘤且临床N0的患者，术后选择性颈部放疗似乎可降低晚期区域复发率。
