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用氮烯咪胺+癌腺治或卡介苗辅助治疗恶性黑色素瘤。

Adjuvant treatment of malignant melanoma with DTIC + estracyt or BCG.

作者信息

Karakousis C P, Emrich L J

机构信息

Department of Surgical Oncology, Roswell Park Memorial Institute, Buffalo, NY 14263.

出版信息

J Surg Oncol. 1987 Dec;36(4):235-8. doi: 10.1002/jso.2930360404.

Abstract

Eighty-two patients with invasive malignant melanoma and no distant metastases were prospectively randomized following their surgical treatment to 1) observation; 2) chemotherapy with Dacarbazine (DTIC) 200 mg/M2 I.V. daily X 5 every 4 weeks and Estracyt 15 mg/kg orally daily for 1 year; and 3) immunotherapy with TICE BCG 1 ml to an area of scarification near the primary site, every 4 weeks for 1 year. At a median follow-up of 73.4 months 31 patients (38%) have relapsed. There was no significant difference in survival according to the treatment, but a weak effect on the course of the disease by either of the treatment protocols cannot be ruled out due to the small sample of patients. Survival and disease-free interval varied significantly according to the histologic status of the regional nodes. The estimated 5-year disease-free rate of patients with negative nodes was 85% and for those with positive nodes it was 35% (P less than 0.0001).

摘要

82例侵袭性恶性黑色素瘤且无远处转移的患者在接受手术治疗后被前瞻性随机分为三组:1)观察组;2)化疗组,采用达卡巴嗪(DTIC)200mg/M²静脉注射,每日1次,共5天,每4周重复,同时口服雌莫司汀15mg/kg,每日1次,持续1年;3)免疫治疗组,采用TICE BCG 1ml在原发病灶附近的划痕处注射,每4周1次,持续1年。中位随访73.4个月时,31例患者(38%)复发。根据治疗方法,生存率无显著差异,但由于患者样本量小,不能排除任何一种治疗方案对疾病进程有微弱影响。生存率和无病生存期根据区域淋巴结的组织学状态有显著差异。淋巴结阴性患者的估计5年无病生存率为85%,淋巴结阳性患者为35%(P<0.0001)。

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