鼻腔鼻窦恶性黑色素瘤6例临床分析

Clinical analysis of 6cases with sinonasal malignant melanoma

目的：探讨鼻腔鼻窦恶性黑色素瘤的临床特点及以手术为主综合治疗鼻腔鼻窦恶性黑色素瘤的疗效。方法：回顾性分析6例鼻腔鼻窦恶性黑色素瘤患者的临床资料,所有患者采取手术加术后适形调强放疗,3例术后加化疗及生物治疗;化疗采用CDBT方案,生物治疗给予INF-α及IL-2。其中2例采取术前1个周期化疗。结果：6例均获随访,生存时间为15~98个月,平均生存时间为62.7个月。1、3及5年生存率分别为100%（6/6）、83%（5/6）和67%（4/6）。手术加放化疗及生物治疗的3例患者（包括术前行化疗的2例）全部生存至今。结论：有手术指证的鼻腔鼻窦恶性黑色素瘤宜采用手术加放化疗及生物治疗的综合治疗模式,对于术前已活检而近期又无法手术的患者,术前先行1个周期的化疗及生物治疗,对提高治疗效果有益。

Objective：To explore cnical characteristics of sinonasal malignant melanoma and curative effect of the combined modality therapy. Method：Clinical data of 6 cases with sinonasal malignant melanoma was retrospectively analyzed. All patients received surgery and postoperative radiotherapy. In addition, 3 cases received postoperative chemotherapy which scheme was CDBT and bioimmunotherapy consisted of INF-α and IL-2 after surgery, of which, 2 cases received one cycle of preoperative chemotherapy. Result： Six cases were followed up. The survival time ranged from 15 months to 98 months. The average survival time was 62.7 months. Analyzed by direct method, the 1-year,3-year and 5-year survival rates were 100%, 83% and 67% respectively. Three cases which received the combined modality therapy, of whch, 2 cases received preoperative chemotherapy have survived by now. Conclusion：The combined modality therapy should be adopted in case of sinonasal malignant melanoma with operation indication. For the patients who can not be operated recently Postbiopsy, it was beneficial to improve the efficacy of therapy that one cycle of preoperative chemotherapy and bioimmunotherapy should be implemented.