恶性黑色素瘤128例临床分析

目的　探讨恶性黑色素瘤的临床分期、治疗方式与 3年生存率关系。方法　通过用常规外科手术、放疗、化疗、冷冻免疫和激光气化术治疗 12 8例恶性黑色素瘤的疗效 (3年生存率 )比较。结果　恶性黑色素瘤 3年生存率与临床分期、治疗方式最密切 ,临床分期越低 ,3年生存率高。冷冻免疫配合激光气化术治疗恶性黑色素瘤 3年生存率最高 ,随后是常规外科手术切除、放疗、化疗。结论　以冷冻免疫为主综合手术切除、放疗、化疗、激光气化是治疗恶性黑色素瘤较有效方法。     

皮肤黑色素瘤的外科治疗现状及研究进展

皮肤黑色素瘤是恶性程度极高的皮肤恶性肿瘤,其恶性程度和死亡率在皮肤恶性肿瘤中占据首位。虽然近年来靶向治疗、免疫治疗、化疗等治疗手段取得了突破性进展,但肿瘤外科手术仍是目前皮肤恶性黑色素瘤患者获得长期生存的主要治疗手段。作者通过对大量皮肤黑色素瘤的外科治疗相关性研究文献的阅读,系统论述了皮肤黑色素瘤的外科治疗的规范。     

白化病合并无色素性恶性黑色素瘤1例报告

恶性黑色素瘤的病因与色素异常有关,白种人较肤色深的人种的发病率高.恶性黑色素瘤在我国发病率较低,而无色素性恶性黑色素瘤仅占恶性黑色素瘤的15%,临床较为少见.恶性黑色素瘤的特点是恶性程度高,易发生转移,预后差.若无播散性转移,治疗可行肿瘤广泛切除术后辅助化疗和生物治疗.最近,我科收治1例白化病合并无色素性恶性黑色素瘤,报告如下.     

皮肤和肢端恶性黑色素瘤的外科治疗规范中国专家共识1.0

恶性黑色素瘤是临床上较为常见且危害严重的恶性肿瘤之一。尽管在我国的发病率较低, 但近年来, 其发病率和死亡率均呈现快速增长趋势。规范化的外科治疗是早中期恶性黑色素瘤获得治愈的关键, 也有助于改善晚期患者的预后, 中国抗癌协会肉瘤专业委员会软组织肿瘤及恶性黑色素瘤学组专家根据中国国情, 以中国临床肿瘤学会黑色素瘤诊疗指南为蓝本, 参考美国国立癌症网络皮肤黑色素瘤诊疗指南、澳洲和新西兰黑色素瘤诊疗指南以及相关国内外黑色素瘤临床研究和荟萃分析, 制订了针对皮肤和肢端黑色素瘤外科治疗的专家共识。此专家共识涵盖了皮肤和肢端黑色素瘤外科治疗各个环节的规范细节和操作要点, 旨在推广皮肤和肢端恶性黑色素瘤的规范外科治疗, 尽可能达到外科治疗目的并最终改善患者的预后。     

皮肤黑色素瘤的外科治疗现状及研究进展

皮肤黑色素瘤是恶性程度极高的皮肤恶性肿瘤,其恶性程度和死亡率在皮肤恶性肿瘤中占据首位。虽然近年来靶向治疗、免疫治疗、化疗等治疗手段取得了突破性进展,但肿瘤外科手术仍是目前皮肤恶性黑色素瘤患者获得长期生存的主要治疗手段。作者通过对大量皮肤黑色素瘤的外科治疗相关性研究文献的阅读,系统论述了皮肤黑色素瘤的外科治疗的规范。     

转移性恶性黑色素瘤分子靶向及免疫治疗进展

黑色素瘤是恶性程度最高的皮肤肿瘤,基于对黑色素瘤细胞的基因突变和免疫系统研究的深入,分子靶向和免疫治疗药物为晚期黑色素瘤带来了新的契机。全文总结近年治疗恶性黑色素瘤靶向药物及相关治疗通路的研究进展。     

重离子12C6+放射治疗黏膜恶性黑色素瘤的临床研究进展

黏膜恶性黑色素瘤是恶性黑色素瘤的一种罕见亚型,发生部位隐匿,临床症状表现多样化。放射治疗对不能手术、术后复发及转移的黏膜恶性黑色素瘤患者而言是一种常用的局部治疗方法。然而,黏膜恶性黑色素瘤对常规射线不敏感,具有辐射抗拒性,因此,放射治疗在黏膜恶性黑素瘤的临床应用中受到一定限制。重离子12C^6+兼具剂量深度分布和生物学效应的双重优势,对肿瘤细胞的杀伤效果明显增强,进而提高了局部肿瘤控制率,故在治疗具有辐射抗性的黏膜恶性黑色素瘤中具有潜在价值。本文就重离子12C6+放射治疗黏膜恶性黑色素瘤的研究进展作一综述。     

恶性黑色素瘤化疗进展

目前,治疗早期恶性黑色素瘤仍以手术切除为主,术后辅以化疗可减少复发;对播散型黑色素瘤,化疗则是重要的治疗手段。本文就单用、联合应用化疗药物治疗恶性黑色素瘤的效果及其研究进展情况进行了综述。     

恶性黑色素瘤的治疗研究进展

恶性黑色素瘤恶性度高,易发生转移,多发于皮肤.不同人种恶性黑色素瘤发病率明显不同,中国发病率较低.全文就恶性黑色素瘤的治疗,从手术、放疗、化疗等各方面作一介绍.     

恶性黑色素瘤128例临床分析

目的 探讨恶性黑色素瘤的临床分期、治疗方式与３年生存率关系。方法 通过用常规外科手术、放疗、化疗、冷冻免疫和激光气化术治疗１２８例恶性黑色素瘤的疗效（３年生存率）比较。结果 恶性黑色素瘤３年生存率与临床分期、治疗方式最密切,临床分期越低,３年生存率高。冷冻免疫配合激光气化术治疗恶性黑色素瘤３年生存率最高,随后是常规外科手术切除、放疗、化疗。结论 以冷冻免疫为主综合手术切除、放疗、化疗、激光气化是治     

头颈部粘膜恶性黑色素瘤临床分析

 目的　探讨头颈部粘膜恶性黑色素瘤的诊断和治疗方法。方法　回顾性分析64例头颈部粘膜恶性黑色素瘤的病例资料,分组统计预后。结果　手术治疗组5年生存率为20%。以手术为主的综合治疗组为21%,非手术治疗组为0。结论　头颈部粘膜恶性黑色素瘤首选手术治疗。免疫组化病理有助确诊。     

头颈部恶性黑色素瘤28例的治疗及预后因素

目的：探讨影响恶性黑色素瘤的治疗及其预后因素。方法：本院头颈外科1984年-1994年10年间诊断28例恶性黑色素瘤,治疗方法分广泛切除,广泛切除加预防性颈清扫术,广泛切除加治疗性颈清扫术3组,并作回顾性分析。结果：28例患者外院局部切除23例,残留率34.8%。原发灶切除范围分≤2cm组及＞2cm组,五年生存率分别为58%及40%。上述3组的五年生存率分别为80%、80%及39%。结论：原发灶的处理要规范,切除范围2cm以内。对颈淋巴结未及肿大的患者可暂不行颈淋巴结清扫术。颈洒巴结阳性患者可依原发灶的部位不同施行不同方式的颈清扫术,并强调颈清扫术中皮片分离应在颈阔肌浅面进行,以减少术后复发。     

头颈部恶性黑色素瘤的临床及病理研究

目的 研究头颈部恶性黑色素瘤的临床,病理及免疫组织化学特片,以提高临床和病理诊断率,方法 收集头颈部恶性黑色素瘤（除脉络膜外）68例,其中原发于鼻腔和口腔黏膜33例,头颈部皮肤35例。发病高峰年龄为41-60岁。52例为手术切除标本,16例为活检（咬取、切除）标本。复习所有患者的临床及病理资料,并对42例进行S-100、HMB45和NSE免疫组织化学观察。结果 在68例中,手术切除者52例,其中有13例行补充放疖1例进行了化疗单纯放疗0例;抿绝治疗6例,在获得随诊的56例中,存活5年以上者12例,其中头颈部皮肤恶性黑色素瘤9例,占75.0%;鼻腔及口腔黏膜者3例外中25.0%。结论 恶性黑色素瘤在组织学结构上的改变具有重要意义;免疫组织化学对恶性黑色素瘤诊断和鉴别诊断有重要价值;发生于鼻腔和口腔黏膜的恶性黑色素瘤的预后明显比发生在头颈部皮肤的差。     

Head and neck melanoma.

BACKGROUND: Melanoma of the head and neck and its treatment are complex issues. The behavior of head and neck melanoma is aggressive, and it has an overall poorer prognosis than that of other skin sites. METHODS: The authors review current data on the treatment of head and neck melanoma, including both cutaneous and mucosal melanoma. RESULTS: Current understanding of the behavior of head and neck melanoma is reviewed and treatment stratagems are presented. Controversies in treatment include lymphoscintigraphy with sentinel node biopsy, nodal dissection, margin size, role of radiation therapy, and reconstruction. The management goal is to treat melanoma aggressively while minimizing the effects of treatment on patient quality of life. CONCLUSIONS: Due to its aggressiveness, head and neck melanoma should be treated aggressively when morbidity is not significantly increased. Patient specific treatment is imperative.     

Mucosal melanomas of the head and neck: new aspects of the clinical outcome, molecular pathology, and treatment with c-kit inhibitors

Approximately 50% of mucosal melanomas affect the head and neck region representing approximately 9% of all malignant head and neck tumors. The pathogenesis of this disease is unknown. Mucosal melanomas are characterized by an aggressive biological behavior, leading to a 5-year survival rate of less than 25%. Data for this review were identified by searches of Medline, Current Contents, PubMed, and references from relevant articles using the terms 'mucosal melanoma,' 'head and neck melanoma,' 'c-kit mutation in melanoma,' and 'c-kit inhibitors'. Therapy aims for the complete surgical excision of the primary tumor, whereas sentinel node biopsy is not established and present data do not support the addition of radiotherapy. Mutilating operations of larger tumors should be avoided, as they do not inhibit the frequent development of distant metastasis. C-kit mutations and amplifications are found in approximately 15-30% of mucosal and acral-lentiginous melanomas. Therefore, the use of so-called targeted therapies addressing molecular structures in mucosal melanomas seem to represent new promising treatment tools. In this study, we review the literature regarding epidemiology, molecular pathology, and therapy of mucosal melanomas of the head and neck emphasizing c-kit protein inhibiting treatment modalities for tumors carrying c-kit mutations.     

口腔粘膜恶性黑色素瘤35例疗效评价

目的 探讨口腔粘膜恶性黑色素瘤的有效治疗手段。方法 回顾分析３５例患者的临床资料。结果 全组总的５年生存率为２８．６％，其中化疗组为０，原发灶扩大切除加化疗组为３０．８％，原发灶扩大切除加颈淋巴清扫加化疗组为４０．０％。结论 以原发灶扩大切除加颈淋巴清扫为主的综合治疗仍为目前治疗口腔粘膜恶性黑色素瘤的有效手段。     

Cutaneous head and neck melanoma: the old and the new

The incidence rate of malignant melanoma has shown a rapid worldwide rise in recent years. The staging and management of head and neck melanoma presents some unique challenges. Surgery remains the cornerstone of treatment, while sentinel node biopsy is the most accurate staging modality for regional disease. The complex regional anatomy and lymphovascular drainage of this region may account for the increased biologic aggressiveness and treatment challenges of this disease. Improved understanding of the radiobiology of melanoma has resulted in new adjuvant radiotherapy approaches, yielding improved control rates. The treatment outcomes of metastatic head and neck melanoma remain disappointing but important progress has been made in the understanding of melanoma biology.     

Melanoma of the head and neck

Opinion statement Staging of cutaneous melanoma has changed in recent years with an increased emphasis upon thickness and ulceration on prognosis of early stage disease. Cutaneous melanoma of the head and neck is treated with complete surgical resection in early stage disease. Resection margins are determined by the size, depth, and presence of satellite lesions. Evaluation for regional and distant metastatic disease is necessary in all cases of advanced stage disease. Sentinel lymph node biopsy and possible parotidectomy and neck dissection should be considered in head and neck cutaneous melanomas greater than 1 mm in thickness or with ulceration. Adjuvant therapy may be indicated in advanced primary, nodal, and metastatic disease. Mucosal melanoma of the head and neck remains a difficult disease to treat, with high locoregional recurrence rates and poor prognosis despite aggressive therapy.     

Epidemiological characteristics of cutaneous malignant melanoma of the head and neck--a population-based study

Since cutaneous malignant melanoma (CMM) and melanoma in situ (MIS) of the head and neck have only partially been differentiated from CMM of other anatomic sites, these lesions are classified in detail in this study. Data from 756 patients derived from the population-based register of the Stockholm-Gotland area were analyzed and the findings showed that the incidence of CMM was 3.4 times higher in the face compared to the skin outside the head-neck area and that lentigo maligna melanoma was 74 times and nodular melanoma 2.3 times more common in the face. Mean age at diagnosis was significantly higher for patients with CMM of the head and neck irrespective of histogenetic type. Tumor site within the head and neck related to age at diagnosis. CMM of the head and neck differs from CMM of other locations. Epidemiological data are in agreement with the hypothesis that UV radiation (chronic or intermittent) may give rise to melanomas with various phenotypic traits.     

Seventy-five cases of solid tumours treated by a modified quadruple chemotherapy regime

Seventy-five cases of malignant solid tumours treated by a quadruple chemotherapy regime are described. These tumours originated in the breast, head and neck, bronchus, genital tract, cutaneous melanoma, soft tissue and gastro-intestinal tract. All 14 patients with breast carcinoma underwent remission and in 6 this was complete. Significant remissions were seen in gastro-intestinal and head and neck malignancies, and also in the soft tissue group. A short response was noted in 6 of 14 cases of bronchial carcinoma. Malignant melanoma, testicular, ovarian and cervical carcinomata failed to respond.