摘要
目的:评价2种辅助治疗方案对口腔黏膜恶性黑色素瘤患者生存率的影响。方法:回顾性生存分析。上颌黏膜恶性黑色素瘤术后患者165例,分为3组:Ⅰ组,单纯手术作为对照组,50例;Ⅱ组:手术+干扰素-α2b治疗组,78例;Ⅲ组:手术+干扰素-α2b+氮烯咪胺治疗组,37例。所有患者AJCC2000分期均为Ⅱ、Ⅲ期。Cox比例风险模型用于预后因素筛选,Kaplan-Meier法计算不同治疗措施下各组的3年累积生存率,Log-rank法用于各组间两两比较。结果:3年总生存率为4%,其中Ⅰ组为3%,Ⅱ组为4.5%,Ⅲ组为5.7%。肿瘤厚度(P<0.001,RR=2.696)、有无破溃(P<0.001,RR=2.068)、淋巴结转移(P<0.001,RR=1.710)和治疗方法(P<0.001,RR=0.395)是影响生存率的主要因素。2种辅助治疗方法对提高生存率均有显著影响(P均<0.01),但2年后作用逐渐减退。2种辅助治疗方法间无统计学差异(P=0.925)。结论:2种辅助治疗措施对提高生存率的影响在2年内显著,随时间逐渐消失。干扰素-α2b+氮烯咪胺方法效果并不优于单纯使用干扰素-α2b。
PURPOSE： To evaluate the effect of two adjuvant therapy in patients with resected maxillary mucosal melanoma. METHODS： Survival analysis, retrospective study. There were 165 patients with resected maxillary mucosal malignant melanoma in the study, which were divided into three group： control group （50）, interferon-α2b group （78） and interferonα2b＋dacarbazine group （37）. All patients had stage II or m lesions according to AJCC（2000） staying system. Cox proportional hazards model was used to analyze the statistically significant prognostic factors. Kaplan-Meire method was used to calculate the cumulated survival rate with 3 different treatments and Log-rank method for comparison of the distribution of the different survival rates in 3 groups. RESULTS： The overall 3-year survival rate was 4%, with 3.0% in the control group, 4.5% in interferon-α2b group and 5.7% in interferon-α2b＋dacarbazine group, respectively. The significant prognostic factors included thickness （P〈0.001, RR=2.696）, ulceration （P〈0.001, RR=2.068）, lymph node metastasis（P〈0.001, RR=1.710） and the treatment method（P〈0.001, RR=0.395）. A beneficial effect in overall survival was observed in two experimental groups. But the effect appeared to become weakening after 2 years. The difference between the two experimental groups was not significant statistically. CONCLUSIONS： The two conjunctive methods used in this study can improve the overall survival in patients with resected maxillary mucosal melanoma. But the beneficial effect would descend and disappear after 2 years . The effect of using interferon-α2b＋dacarbazine was not better than that of using interferon-α2b alone.
出处
《上海口腔医学》
CAS
CSCD
2006年第3期263-268,共6页
Shanghai Journal of Stomatology
