前哨淋巴结活检结合大剂量干扰素治疗提高下肢恶性黑色素瘤疗效的分析

Role of sentinel lymph node biopsy and high-dose of interferon adjuvant therapy in lower limbs malignant melanoma

目的：探讨恶性黑色素瘤前哨淋巴结活检结合大剂量干扰素治疗对肿瘤疗效的影响。方法：2011年6月至2014年6月共收治30例下肢恶性黑色素瘤患者,其中男17例,女13例;平均年龄56岁（17~75岁）;病程1个月~5年。30例患者术中均行前哨淋巴结活检及病灶扩大切除,术后均采用大剂量干扰素治疗。结果：30例患者中,22例术中前哨淋巴结见肿瘤转移,24例加行腹股沟淋巴结清扫术。术后26例患者耐受大剂量干扰素治疗,并完成疗程。主要的不良反应有流感样症状、粒细胞减少、肝功能异常及胃肠道反应。2例患者3个月内出现进展。结论：扩大切除原发病灶,同时做腹股沟前哨淋巴结活检,活检阳性者行腹股沟淋巴结清扫结合术后大剂量干扰素治疗,对下肢恶性黑色素瘤患者有重要的治疗意义。

Objective： To investigate the effects of sentinel lymph node biopsy（ SLNB） and high-dose of interferon adjuvant therapy in lower limbs malignant melanoma. Methods： From June 2011 to June 2014,thirty patients with lower limbs malignant melanoma were treated. There were 17 males and 13 females,aging 17 to 75 years. The disease courses were 1 month to 5 years. SLNB was done before surgery,and high-dose of interferon adjuvant therapy was used after surgery. Results： The lymph nodes of SLNB were positive in twenty-two patients and twenty-four patients were received lymphadenectomy. Twenty-six patients successfully finished the high-dose of interferon adjuvant therapy and the main side effects were flu like symptoms,neutropenia,abnormal liver function and gastrointestinal tract reaction. Two patients were progressive in three months. Conclusion： SLNB and highdose of interferon adjuvant therapy are effective and well tolerated in lower limbs malignant melanoma.