Langmann G, Wackernagel W, Stücklschweiger G, Feichtinger K, Papaefthymiou G, Faulborn J
Universitäts-Augenklinik, Graz.
Ophthalmologe. 2004 Nov;101(11):1111-9. doi: 10.1007/s00347-003-0984-y.
To evaluate tumor regression and sequelae in 30 uveal melanomas treated with Gamma Knife radiosurgery between 1992 and 1995 at the Gamma Knife center in Graz.
A total of 30 uveal and ciliary body melanomas were treated with a single fraction of the Gamma Knife. The mean marginal dose was 52.1 Gy, (median 50 Gy). Of the tumors, 15 were large (higher than 8 mm), 14 were medium sized (3-8 mm) and one was a small melanoma (<3 mm). Among them were 6 juxtapapillary, 10 (juxta-) maculary melanomas, 5 tumors located in the midperiphery and 9 ciliary body melanomas.
Dose-volume histogram analysis.
After a maximum follow up of 9 years and 7 months, 8 tumors regressed into a scar, 17 tumors into a residual prominence between 50% and 80% of the initial tumor height, 3 tumors showed no change and in 2 patients recurrence was obvious. Sequelae were classified as mild (in 3 patients), moderate (3), severe (5) and very severe (19).
Significant factors for the development of severe sequelae were the tumor volume and the marginal dose, the mean dose proved to be more important than the marginal dose and the irradiated volume more important than the selective critical dose.
评估1992年至1995年在格拉茨伽玛刀中心接受伽玛刀放射外科治疗的30例葡萄膜黑色素瘤的肿瘤消退情况及后遗症。
总共30例葡萄膜和睫状体黑色素瘤接受了单次伽玛刀治疗。平均边缘剂量为52.1 Gy（中位数50 Gy）。其中，15例为大肿瘤（直径大于8 mm），14例为中等大小肿瘤（3 - 8 mm），1例为小黑色素瘤（直径小于3 mm）。其中有6例紧邻视乳头，10例（紧邻）黄斑黑色素瘤，5例位于中周边部，9例睫状体黑色素瘤。
剂量体积直方图分析。
在最长9年7个月的随访后，8例肿瘤消退为瘢痕，17例肿瘤消退为残留隆起，高度为初始肿瘤高度的50%至80%，3例肿瘤无变化，2例患者复发明显。后遗症分为轻度（3例患者）、中度（3例）、重度（5例）和极重度（19例）。
发生严重后遗症的重要因素是肿瘤体积和边缘剂量，平均剂量被证明比边缘剂量更重要，照射体积比选择性临界剂量更重要。
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