Kim Y H, Jensen R A, Watanabe G L, Varghese A, Hoppe R T
Department of Dermatology, Stanford University School of Medicine, Calif, USA.
Arch Dermatol. 1996 Nov;132(11):1309-13.
To study the long-term results of treatment of patients with stage IA mycosis fungoides and analyze the factors related to disease progression and the effect of initial therapy on survival and freedom from relapse.
A single-center, 32(1/2)-year, retrospective cohort analysis.
Private referral medical center.
One hundred twenty-two patients with clinical stage IA (T1, N0, M0) mycosis fungoides.
Long-term actuarial survival and freedom-from-relapse results as calculated by the technique of Kaplan-Meier.
The long-term (30-year) survival of patients with stage IA mycosis fungoides is similar to the expected survival of a race-, age-, and sex-matched control population. The median survival of this group has not been reached at 32(1/2)-years. Eleven patients (9%) who progressed to more advanced disease had a lower complete response rate to initial therapy than did other patients (36% vs 82%) and an older mean age than did other patients with T1 disease (61 vs 48 years, P < .05). Only 3 (2%) of 122 patients died of disease. Among stage IA patients who achieved a complete response, 25% are relapse free at 10 years. Patients who received total skin electron beam therapy (n = 34) had a more favorable freedom-from-relapse outcome than those treated with topical mechlorethamine hydrochloride (nitrogen mustard) (n = 73, P < .05). No significant difference was seen in the long-term survival between the 2 treatment groups.
Patients with clinical stage IA mycosis fungoides treated at Stanford University do not have an altered life expectancy. Fewer than 10% progressed to more advanced stages and few died of disease. Although the response rate to total skin electron beam therapy was superior to that of topical mechlorethamine, the longterm survival results were similar. Topical mechlorethamine is a cost-effective and convenient therapy for patients with limited patch and plaque mycosis fungoides.
研究IA期蕈样肉芽肿患者的长期治疗结果，分析与疾病进展相关的因素以及初始治疗对生存和无复发的影响。
单中心、32.5年的回顾性队列分析。
私立转诊医疗中心。
122例临床IA期（T1，N0，M0）蕈样肉芽肿患者。
采用Kaplan-Meier技术计算的长期精算生存率和无复发结果。
IA期蕈样肉芽肿患者的长期（30年）生存率与种族、年龄和性别匹配的对照人群的预期生存率相似。该组患者的中位生存期在32.5年时尚未达到。11例（9%）病情进展至更晚期的患者对初始治疗的完全缓解率低于其他患者（36%对82%），且平均年龄高于其他T1期疾病患者（61岁对48岁，P<.05）。122例患者中仅3例（2%）死于该疾病。在达到完全缓解的IA期患者中，25%在10年时无复发。接受全身皮肤电子束治疗的患者（n=34）比接受局部盐酸氮芥治疗的患者（n=73）有更有利的无复发结局（P<.05）。两个治疗组的长期生存率无显著差异。
在斯坦福大学接受治疗的临床IA期蕈样肉芽肿患者的预期寿命未改变。进展至更晚期的患者少于10%，死于该疾病的患者很少。虽然全身皮肤电子束治疗的缓解率优于局部盐酸氮芥，但长期生存结果相似。局部盐酸氮芥对于局限性斑片和斑块型蕈样肉芽肿患者是一种经济有效且方便的治疗方法。
