鼻黏膜恶性黑色素瘤综合治疗的预后分析

Prognosis analysis of multidisciplinary treatment on nasal mucosa malignant melanoma

目的:探讨影响原发性鼻黏膜恶性黑色素瘤预后的因素并分析最佳治疗策略。方法:原发性鼻黏膜恶性黑色素瘤患者33例,其中接受手术治疗者26例,放疗19例,手术辅助生物治疗21例。采用Kaplan-Meier法、Log-rank单因素法分析不同治疗方式对患者预后的影响。结果:33例患者3年累积生存率为48.3%,5年累积生存率为30.3%。是否行手术治疗是影响患者5年生存率的重要因素(P<0.05),是否行放疗或生物治疗对5年生存率无影响(均P>0.05)。结论:鼻黏膜恶性黑色素瘤首要的一线治疗方法为手术治疗,鼻内镜手术治疗效果良好;辅助放疗可提高肿瘤的局部控制率;免疫治疗是目前治疗鼻黏膜恶性黑色素瘤的发展方向。

Objective：The aim of this study is to investigate the facters affecting prognosis of primary sinonasal mucosal malignant melanoma and analyze the optimal therapeutic strategies.Method：Among the 33 patients with sinonasal mucosal malignant melanoma,twenty-six patients received surgical treatment,nineteen patients accepted radiotherapy,and twenty-one patients had the biotherapy.The Kaplan-Meier and log-rank methods was used to assess the prognosis of different treatment.Result：the patient＇s 3-year-survival rate was 48.3%and 5-year-survival rate was 30.3%.Surgical treatment is the important factor for the 5-year-survival rate（P0.05）,while the chemotherapy and biotherapy had no effect on overall survival rate（P0.05）.Conclusion：The surgical treatment is the preferred method of treatment,and endoscopic surgery has the satisfactory effect.Adjuvant radiotherapy can improve local tumor control rates.Immunotherapy is the development direction of treatment for nasal mucosal malignant melanoma.