Sobrin Lucia, Schiffman Joyce C, Markoe Arnold M, Murray Timothy G
Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida, USA.
Ophthalmology. 2005 Oct;112(10):1777-83. doi: 10.1016/j.ophtha.2005.05.003.
To determine the visual and survival outcomes for patients undergoing plaque radiotherapy of suspected small choroidal melanomas after observation for growth in a pilot study.
Noncomparative interventional case series.
Forty-five patients with suspected small choroidal melanomas who were seen at the Bascom Palmer Eye Institute between 1974 and 2001 and had iodine 125 (I125) plaque radiotherapy between 1991 and 2002.
Patients with suspected small choroidal melanomas were monitored by clinical examination, photography, and echography. When the melanoma grew or developed orange pigment, patients were treated with I125 plaque radiotherapy. Outcomes included visual acuity, ocular complications, tumor dimensions, metastasis, and death.
Melanoma-specific mortality.
In our pilot study, 1 patient died from metastatic melanoma. One patient developed metastatic disease and is still alive. One patient developed marginal tumor recurrence after treatment and after enucleation was performed. Globe conservation was achieved in 97.8% of patients. In patients with tumor margins >2 mm from the optic nerve, vision was preserved with less than a doubling of the visual angle (within approximately 2 Snellen lines of preoperative acuity) in 90.6% (29/32) of patients at 1 year postoperatively, 65.6% (21/32) at 2 years, and 52.2% (12/23) in the long term (4-11 years).
Five-year melanoma-specific mortality after I125 plaque radiotherapy of suspected small choroidal melanomas was 3.9% (95% confidence interval, 0%-11.2%). This information can be used to counsel patients with small suspected choroidal melanomas and to compare with other treatment modalities.
在一项初步研究中，观察疑似小脉络膜黑色素瘤生长情况后，确定接受斑块放射治疗患者的视力和生存结局。
非对照干预性病例系列研究。
1974年至2001年间在巴斯科姆·帕尔默眼科研究所就诊、1991年至2002年间接受碘125（I125）斑块放射治疗的45例疑似小脉络膜黑色素瘤患者。
通过临床检查、摄影和超声检查对疑似小脉络膜黑色素瘤患者进行监测。当黑色素瘤生长或出现橙色色素时，对患者进行I125斑块放射治疗。结局指标包括视力、眼部并发症、肿瘤大小、转移和死亡。
黑色素瘤特异性死亡率。
在我们的初步研究中，1例患者死于转移性黑色素瘤。1例患者发生转移性疾病，仍存活。1例患者治疗后出现边缘肿瘤复发，之后接受了眼球摘除术。97.8%的患者实现了眼球保留。在肿瘤边缘距视神经>2 mm的患者中，术后1年90.6%（29/32）的患者视力得以保留，视角增加不到一倍（在术前视力约2行斯内伦视力表范围内），2年时为65.6%（21/32），长期（4 - 11年）为52.2%（12/23）。
疑似小脉络膜黑色素瘤I125斑块放射治疗后的五年黑色素瘤特异性死亡率为3.9%（95%置信区间，0% - 11.2%）。该信息可用于为疑似小脉络膜黑色素瘤患者提供咨询，并与其他治疗方式进行比较。
