【摘要】 目的:探讨口腔颌面部黑色素瘤各种治疗方法的疗效。方法:回顾性总结中山医科大学肿瘤防治中心头颈科1970年1月1日～1998年12月30日收治口腔颌面部黑色素瘤患者66例,Ⅰ期10例,Ⅱ期16例,Ⅲ期27例,Ⅳ期13例;采用单纯手术治疗35例,手术加化疗15例,单纯化疗5例,手术加放疗4例,手术加化疗及生物治疗3例。结果:本组3年、5年及10年生存率分别为38.7%、24.7%和17.3%。Ⅰ～Ⅳ期的3年生存率分别是80%、72.9%、15.9%和0,5年生存率分别为69.3%、53.2%、5.3%和0。单纯手术组的3、5年生存率分别为26.4%和13.2%,手术加化疗组的3、5年生存率分别为76.2%和55.9%。手术病例的原发灶复发率为53.3%。48例死于肿瘤,死亡率为72.7%;死亡病例的远处转移率为72.9%,是死亡的第一位原因。结论:以手术广泛切除为主的综合治疗是黑色素瘤较为合理的治疗,治疗性颈清扫术是必须的;辅助化疗有助于减少远处转移,提高疗效。更多还原

【Abstract】 Objective: This study retrospectively evaluates the therapies for the patients with oral and maxillofacial melanoma. Methods: Sixty six patients with oral and maxillofacial melanoma were treated at Cancer Center, Sun Yat sen University of Medical Sciences from Jan 1, 1970 to Dec 30, 1998. There are 10 in stage Ⅰ, 16 in stage Ⅱ, 27 in stage Ⅲ, and 13 in stage Ⅳ. Thirty five patients were treated with surgery. Fifteen patients were treated with surgery combined with chemotherapy. Five patients were treated with chemotherapy. Four patients treated with surgery combined with radiotherapy. Three patients were treated with surgery combined with chemotherapy and biotherapy. Results: The followed up rate was 93.9%. The 3 year, 5 year, and 10 year survival rates were 38.7%, 24.7%,and 17.3%, respectively. The 3 year survival rates for stages Ⅰ-Ⅳ were 80%,72.9%,15.9%,and 0%, respectively. The 5 year survival rates for stages I-Ⅳ were 69.3%,53.2%,5.3%,and 0%, respectively. The 3 year and 5 year survival rates of the subgroup of surgery were 26.4% and 13.2%. The 3 year and 5 year survival rates of the subgroup of surgery combined with chemotherapy were 76.2% and 55.9%. The recurrent rate of primary tumor was 53.3%. Forty eight patients died of tumor. There was a 72.7% mortality rate and distant metastasis was the first reason of death (72.9%). Conclusions: The combined management based on radical excision and adjunctive chemotherapy should be carried out on patients with oral and maxillofacial melanoma. Radical neck dissection is necessary for the patients.更多还原