Mueller A J, Talies S, Schaller U C, Horstmann G, Wowra B, Kampik A
Eye Clinic of the University, Klinikum Innenstadt, Muenchen, Germany.
Ophthalmology. 2000 Jul;107(7):1381-7; discussion 1387-8. doi: 10.1016/s0161-6420(00)00150-0.
To present our experience with the Gamma-knife in treating large uveal melanomas with stereotactic radiosurgery.
Prospective, noncomparative, interventional case series.
Fifty-eight patients with unilateral uveal melanomas were treated from 1996 through 1999 with stereotactic radiosurgery using the Gamma-knife. From these we report the results of 35 patients who had a follow-up of more than 1 year after irradiation.
Stereotactic radiosurgery with the Gamma-knife.
Tumor control, maximum apical tumor height, eye retention rate, and visual acuity.
In 34 eyes (97%), local tumor control was achieved. The maximum apical tumor height decreased from a median of 9.1 mm (95% confidence interval [CI], 3.2-13.9 mm) before treatment to 6.2 mm (95% CI, 2.1-11.9 mm) at 1 year after treatment (P<0.001, paired t test). The tumor volume decreased from a median of 0.8 cm(3) before treatment to 0.5 cm(3) 1 year after treatment (P<0.001, paired t test). Two eyes required enucleation (one radiation failure, one secondary glaucoma). The median visual acuity decreased from 20/60 (95% CI, hand movement [HM] to 20/20) before treatment to 20/200 (95% CI, HM to 20/30) at 1 year after treatment (P = 0.001, paired t test).
Stereotactic radiosurgery using the Gamma-knife is an alternative to enucleation in treating large uveal melanomas. The visual function may be preserved in selected cases.
介绍我们使用伽玛刀立体定向放射外科治疗大型葡萄膜黑色素瘤的经验。
前瞻性、非对照、干预性病例系列。
1996年至1999年，58例单侧葡萄膜黑色素瘤患者接受了伽玛刀立体定向放射外科治疗。我们报告其中35例患者放疗后随访超过1年的结果。
伽玛刀立体定向放射外科治疗。
肿瘤控制情况、肿瘤顶端最大高度、眼球保留率和视力。
34只眼（97%）实现了局部肿瘤控制。肿瘤顶端最大高度从中位数9.1毫米（95%可信区间[CI]，3.2 - 13.9毫米）治疗前降至治疗后1年时的6.2毫米（95%CI，2.1 - 11.9毫米）（P<0.001，配对t检验）。肿瘤体积从中位数0.8立方厘米治疗前降至治疗后1年时的0.5立方厘米（P<0.001，配对t检验）。2只眼需要摘除眼球（1例放疗失败，1例继发性青光眼）。视力中位数从治疗前的20/60（95%CI，手动[HM]至20/20）降至治疗后1年时的20/200（95%CI，HM至20/30）（P = 0.001，配对t检验）。
使用伽玛刀立体定向放射外科治疗大型葡萄膜黑色素瘤是眼球摘除术的一种替代方法。在部分病例中可保留视觉功能。
