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目的:评价不同术后辅助治疗方案及临床病理参数对Ⅲ期恶性黑色素瘤患者无病生存(DFS)的影响。方法:收集2006年1月至2012年1月新疆医科大学附属肿瘤医院收治的130例Ⅲ期恶性黑色素瘤患者的临床资料,患者均接受规范的手术治疗,分为3组:(1)氮烯咪胺组:42例为(2006-2009年),患者接受氮烯咪胺(400 mg,d1-4,4~6个周期;)(2)干扰素组:63例(2009-2012年),患者接受大剂量干扰素治疗(α-2b干扰素,2 200万U静脉输注,每周5次,共4周,900万U皮下注射,每周3次,共1 1个月);(3)未治疗组(25例):因经济等问题术后未接受任何治疗。结果:随访时间为4~76个月,中位随访时间31个月。氮烯咪胺组、干扰素组、未治疗组患者DFS分别为(31.0±2.5)月、(24.0±1.8)月、(15.1±1.3)月。3组比较,差异有统计学意义(P<0.05)。接受辅助治疗者DFS较未接受辅助治疗者长;大剂量干扰素治疗延长DFS最为显著(P<0.05)。年龄、病理类型、原发灶厚度、有无溃疡等因素均不影响DFS(P>0.05)。结论:Ⅲ期黑色素瘤患者,常见临床病理参数对DFS无影响,治疗应以规范综合治疗为主,大剂量干扰素治疗可延长恶性黑素瘤患者DFS,效果及安全性较好,值得推广。
Objective: To evaluate the effect of postoperative adjuvant therapy and clinicopathological parameters on disease-free survival (DFS) in patients with stage Ⅲ malignant melanoma. METHODS: The clinical data of 130 patients with stage Ⅲ malignant melanoma who were admitted to Cancer Hospital of Xinjiang Medical University from January 2006 to January 2012 were enrolled in this study. Patients were divided into three groups: (1) Melamine group: 42 patients (2006-2009), patients receiving dacarbazine (400 mg, d1-4, 4 to 6 cycles) (2) Interferon group: 63 patients (2009-2012) Patients were treated with high-dose interferon (interferon alfa-2b, 22 million U intravenous infusion, 5 times a week for 4 weeks, 9 million U subcutaneously 3 times a week for 11 months); (3) untreated group (25 cases): due to economic problems such as postoperative did not receive any treatment. Results: The follow-up time ranged from 4 to 76 months with a median follow-up of 31 months. The DFS of patients in the enamel group, interferon group and untreated group were (31.0 ± 2.5) months, (24.0 ± 1.8) months and (15.1 ± 1.3) months, respectively. The difference between the three groups was statistically significant (P <0.05). Patients receiving adjuvant DFS were longer than those who did not receive adjuvant therapy; and those receiving extended-dose interferon therapy had the most prolonged DFS (P <0.05). Age, pathological type, thickness of primary tumor, presence or absence of ulcer and other factors did not affect DFS (P> 0.05). Conclusion: The common clinical and pathological parameters of patients with stage Ⅲ melanoma have no effect on DFS. The treatment should be based on standardized comprehensive therapy. High-dose interferon can prolong the DFS in patients with malignant melanoma, which is worthy of promotion.