手术联合小剂量干扰素治疗早期皮肤黑素瘤31例临床分析并文献复习

发布时间：2018-05-04 07:17

  本文选题：黑素瘤 + 手术　； 参考：《中国皮肤性病学杂志》2017年06期

【摘要】：目的探讨手术联合小剂量干扰素治疗早期皮肤黑素瘤的临床疗效和安全性。方法回顾本科2007年4月-2011年3月收治的早期皮肤黑素瘤患者的临床资料。结果 31例患者中,男17例,女14例;年龄42~77岁,病程3个月~6年,术前均未见局部淋巴结转移或远处转移灶,临床上属Ⅰa~Ⅱc期,予皮损扩大切除(或截肢)加植皮或皮瓣修复术联合小剂量干扰素(300万U,3次/周)治疗18个月后,21例切口愈合良好,随访5年无复发,肿瘤厚(2.11±0.86)mm。10例于术后4~25个月时复发,其中1例Ⅱa期,6例Ⅱb期,3例Ⅱc期,肿瘤厚(3.62±1.16)mm。4例因黑素瘤转移死亡,其中1例Ⅱb期,3例Ⅱc期。27例存活患者中有1例白细胞下降显著而停止干扰素注射。总生存率87.10%,无病生存期44.1个月,5年无复发生存率67.74%。结论手术切除联合干扰素治疗早期皮肤黑素瘤预后尚可,与术后联合大剂量干扰素相比,疗效相似,且不良反应相对较轻,患者的依从性高,但是疗效可能受肿瘤的病理类型、厚度和分期影响。
[Abstract]:Objective to evaluate the efficacy and safety of low-dose interferon in the treatment of early cutaneous melanoma. Methods the clinical data of patients with early cutaneous melanoma from April 2007 to March 2011 were reviewed. Results among the 31 patients, 17 were male and 14 were female, aged 42 to 77 years, the course of disease was from 3 months to 6 years. No local lymph node metastasis or distant metastasis was found before operation. After 18 months of extensive excision (or amputation) and skin graft or flap repair combined with low dose interferon (3 million UU 3 times / week), 21 cases of incision healed well, and no recurrence occurred in the follow-up of 5 years. Tumor thickness of 2.11 卤0.86)mm.10 recurred at 4 ~ 25 months after operation. One patient with stage 鈪，

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