生物化疗法治疗恶性黑色素瘤临床疗效研究

The Efficacy of Bio-chemotherapy for Malignant Melanoma

目的：探讨生物化疗法治疗恶性黑色素瘤的临床疗效.方法：将60例III、IV期恶性黑色素瘤患者随机分为化学治疗组、生物治疗组和生物化疗组各20例,化学治疗组给予顺铂、达卡巴嗪、福莫司汀和他莫昔芬治疗,生物治疗组给予INF-α、IL-2和树突状细胞治疗,生物化疗组则联合上述治疗,观察其临床疗效及毒副作用.结果：近期疗效方面,化学治疗组总有效率为40.0%,生物治疗组总有效率为25.0%,生物化疗组总有效率为66.5%,生物化疗组显著高于化学治疗组和生物治疗组（P〈0.01）;远期疗效方面,生物治疗组和生物化疗组中位生存时间（MST）、两年存活率均显著优于化学治疗组（P〈0.05）,但其两组差异无统计学意义（P〉0.05）;毒副作用方面,三组均出现不同程度的毒副作用,经对症处理后均好转,患者可耐受.结论：生物化疗法治疗恶性黑色素瘤疗效确切,可显著延长患者的生存时间,安全可靠,值得临床推广应用.

Objective：To investigate the efficacy of bio-chemotherapy for malignant melanoma. Methods：60 cases of patients with III and IV stage of malignant melanoma randomly divided into chemotherapy group （20 cases）, biotherapy group （20 cases） and bio-chemotherapy group （20 cases）, the chemotherapy group treated by cis-platinum complexes, dacarbazine, fotemustine and tamoxifen, the biotherapy group treated by INF-a, IL-2 anddendritic cells, while bio-chemotherapy group treated by combination treatment, observed the efficacy and adverse actions of the three groups. Re-sults：At the short-term efficacy, the overall response rate of chemotherapy group, biotherapy group and bio-chemothearpy group were 40.0%, 25.0%and 66.5%, the rate of bio-chemotherapy group was significantly higher than those of chemotherapy group and biotherapy group （P〈0.01）; at the long-term efficacy, the MST and 2 year survival rate of biotherapy group and bio-chemotherapy group were significantly better than that of chemo-therapy group （P〈0.05）, but there was no significant difference between those two groups （P〉0.05）;at the adverse actions, all of the three groups had occurred different degree of adverse actions, and all turned better after symptomatic treatment, the patients were tolerable. Conclusion：The treatment of bio-chemotherapy has a significant curative effect on malignant melanoma, which can significantly prolong the survival time of patients, safe and reliable, deserves clinical promotion and application.