91例恶性小晶状体放射治疗的单中心回顾性研究

IF 3.1 4区医学 Q2 DERMATOLOGY

Annales De Dermatologie Et De Venereologie Pub Date : 2025-03-01 DOI:10.1016/j.annder.2025.103342

D. Canu , R. Kabore , O. Cogrel , A. Lamoureux , E. Gerard , N. Ouhabrache , M. Beylot-Barry

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引用次数: 0

摘要

背景：恶性lentigo （LM）是一种黑色素瘤亚型，发生在老年人晒伤皮肤上。从LM发展而来的皮肤浸润性黑色素瘤被称为LM黑色素瘤（LMM），其预后与其他黑色素瘤亚型相同。LM的标准治疗是手术，它提供了最低的复发风险。然而，也存在其他选择，包括放射治疗（RT）。目的：描述一个接受放疗的LM/LMM患者的现实队列，并评估复发的预后因素。方法本研究是在波尔多大学医院进行的回顾性单中心现实研究。2009年至2020年期间接受RT治疗的所有LM或LMM患者均被纳入研究。RT使用浅表或正电压x射线（kV）进行，剂量为40 Gy，分10次，持续5 周。结果共纳入91例患者：LM 67例，LMM 24例。女性64例，LM组平均年龄77岁（50 ~ 96岁），LMM组平均年龄80岁（56 ~ 98岁）。平均rt后随访时间为25.1 个月（范围：0-100）。复发14例（15.4%）：LM组10例（14.9%），LMM组4例（16.7%）。复发多发生在照射区：LM组8/10，LMM组2/4。与其他部位相比，男性（6/27 vs 8/64）和眼睑区域（4/14）的复发率更高。既往至少有一次治疗失败的患者复发风险也更高(8/36 （22.2%)vs 6/55(10.9%)）。与部分缓解的患者相比，在3 个月达到完全缓解的患者的复发率显著减少（7.1% vs 28.6%, p = 0.0159）。结论对部分LM患者，放疗可作为手术治疗的替代方案。

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Radiation therapy on lentigo maligna: A single-centre retrospective study on 91 patients

Background

Lentigo maligna (LM) is a melanoma subtype that occurs on sun-damaged skin in the elderly. Dermal invasive melanoma developing from LM is called LM melanoma (LMM) and has the same prognosis as other melanoma subtypes. The standard treatment for LM is surgery, which offers the lowest risk of recurrence. Alternatives exist, however, including radiotherapy (RT).

Objective

Describe a real-life cohort of patients with LM/LMM treated with RT and assess prognostic factors for recurrence.

Method

This is a retrospective monocentric real-life study conducted in Bordeaux University Hospital. All LM or LMM patients treated with RT between 2009 and 2020 were included. RT was administered using a superficial or orthovoltage X-ray (kV) with a dose of 40 Gy in 10 fractions over 5 weeks.

Results

Ninety-one patients were included: 67 LM and 24 LMM. Sixty-four patients were female, the mean age was 77 (range: 50‑96) in LM group, and 80 (range: 56–98) in LMM group. The mean duration of post-RT follow-up was 25.1 months (range: 0–100). Fourteen recurrences were observed (15.4%): 10 in LM group (14.9%) and 4 in LMM group (16.7%). Most recurrences occurred in the irradiation field: 8/10 in LM group, and 2/4 in LMM group. Recurrences were more frequent in men (6/27 vs 8/64) and on the eyelid area (4/14) compared to others locations. The risk of recurrence was also higher in patients with at least one prior treatment failure (8/36 (22.2%) vs 6/55 (10.9%)). There were significantly fewer recurrences for patients who had achieved a complete response at 3 months compared to those with a partial response (7.1% vs 28.6%, p = 0.0159).

Conclusion

Radiotherapy is a therapeutic alternative to surgery to be considered for selected patients with LM.

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来源期刊

Annales De Dermatologie Et De Venereologie 医学-皮肤病学

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

81 days

期刊介绍： Les Annales de dermatologie sont le rendez-vous mensuel incontournable de toute la dermatologie francophone, grâce à leur comité de rédaction qui assure une sélection rigoureuse des articles selon les normes de l''édition scientifique internationale. Une revue didactique, véritable aide à la pratique médicale quotidienne Pour compléter et enrichir la partie scientifique, la rubrique Formation médicale continue propose aux lecteurs des textes didactiques et interactifs (Cas pour diagnostic, Notes de pharmacovigilance, la Question du praticien, Dermatologie chirurgicale, la Sélection bibliographique du mois...) qui les font bénéficier d''une formation post-universitaire diversifiée et de qualité. La revue consacre également un espace pour la publication de questions des lecteurs auxquelles des experts apportent une réponse.