[Adjuvant chemotherapy as a component of complex treatment for skin melanoma]

The efficacy of adjuvant chemotherapy as a component of complex treatment for skin melanoma and that of combined treatment alone was compared. 502 patients were given combined treatment including intensive preoperative irradiation of primary foci (STD-19Gy, TTD-50 Gy, 5 days), their extended excision with or without lymphadenectomy and postoperative irradiation of regional lymph nodes. Combined treatment was administered to 124 patients; additional adjuvant chemotherapy--5-fluorouracil, methotrexate, vincristine and cyclophosphamide (4 components)--200; neo- and adjuvant chemotherapy with cisplatin and doxorubicin (2 components)--106; cisplatin, doxorubicin and dacarbazine (3 components)--29. Forty-three patients receiving individualized chemotherapy were not included in the study. None of the 502 patients showed local recurrence. Five-year actuarial survival in combined treatment group was 69.2 +/- 4.4% (M +/- m), 4-component therapy--58.2 +/- 3.6%, 2 components--68.7 +/- 4.9% and 3 components--80.0 +/- 8.3% (p > 0.2); 5-year recurrence-free survival- 68.1 +/- 4.4%, 57.5 +/- 3.6%; 63.1 +/- 5.0% and 60.9 +/- 10.0% respectively. No significant differences were found as far as a correlation was concerned between actuarial survival and recurrence-free one, on the one hand, and tumor stage, depth and extent of invasion, on the other. Hence, no beneficial effect of said adjuvant chemotherapeutic measures on combined treatment for locally-advanced skin melanoma was found.