[葡萄膜黑色素瘤的放射外科初步结果]
[Preliminary results of radiosurgery for uveal melanoma].
作者信息
Xiao Jian-ping, Xu Guo-zhen, Miao Yan-jun, Wei Wen-bin, Hu Shi-min, Tang Xin, Wang Jing-zhao, Wang Guang-lu
机构信息
Department of Radiation Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
出版信息
Zhonghua Zhong Liu Za Zhi. 2005 Apr;27(4):241-4.
OBJECTIVE
To evaluate the clinical value of stereotactic radiosurgery (SRS) for uveal melanoma.
METHODS
From Jan, 1996 to March, 2004, 16 patients with uveal melanoma were treated with SRS, two by one session (35 Gy, 25 Gy) and fourteen by fractionated SRS (30-55 Gy/2-4F/4-16D). The follow-up period ranged from 3 to 100 months (median: 66 months).
RESULTS
All 16 patients were still alive though all were blind in the diseased eye during recent follow-up. Local control rate was 93.4%, 5-year survival rate of 13 patients who have been followed for more than 5 years, was 100% (13/13). However, 7 patients received eyeball enucleation due to corneal ulcer (n = 2), suspicion for uncontrolled tumor (n = 2) and secondary glaucoma (n = 3). One patient developed distant metastasis, though still alive.
CONCLUSION
Fractionated radiosurgery is safe and effective for uveal melanoma. It is indicated for lesions of limited size (longest diameter < 20 mm, depth < 15 mm) located in the posterior pole or behind the equator at the back of the eyeball.
目的
评估立体定向放射外科治疗（SRS）对葡萄膜黑色素瘤的临床价值。
方法
1996年1月至2004年3月，16例葡萄膜黑色素瘤患者接受SRS治疗，2例单次治疗（35 Gy，25 Gy），14例分次SRS治疗（30 - 55 Gy/2 - 4F/4 - 16D）。随访时间为3至100个月（中位数：66个月）。
结果
在最近的随访中，所有16例患者均存活，但患眼均失明。局部控制率为93.4%，13例随访超过5年的患者5年生存率为100%（13/13）。然而，7例患者因角膜溃疡（n = 2）、怀疑肿瘤未控（n = 2）和继发性青光眼（n = 3）而接受眼球摘除术。1例患者发生远处转移，但仍存活。
结论
分次放射外科治疗对葡萄膜黑色素瘤安全有效。适用于位于眼球后极或赤道后方、大小有限（最长直径<20 mm，深度<15 mm）的病变。
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