Donaldson David, Sansom Jane, Adams Vicky
Comparative Ophthalmology Unit, Center for Preventive Medicine, Animal Health Trust, Lanwades Park, Kentford CB8 7UU, UK.
Vet Ophthalmol. 2006 May-Jun;9(3):179-85. doi: 10.1111/j.1463-5224.2006.00468.x.
To evaluate the efficacy of lamellar resection and adjunctive 90Sr-beta plesiotherapy in the management of canine limbal melanoma and the frequency and morbidity of early and late-onset side effects following treatment.
Retrospective study.
Thirty dogs treated for limbal melanoma at the Animal Health Trust (AHT), between 1992 and 2004.
Medical records were reviewed and information collected on the radiation dose administered, duration of follow-up, and the frequency of early- and late-onset ocular side effects. Follow-up information was obtained by re-examination of patients or completion of a telephone interview with the referring veterinary surgeons or the owners.
Recurrence of limbal melanoma occurred in 1 of 30 cases (3%; 95% CI: 0.2-14%). One or more side effects occurred in 16 of 30 cases (53%; 95% CI: 28.1-74.9). The occurrence of side effects was not associated with the number of sites treated or the total surface dose of radiation. Short-term side effects were reported in 16/30 cases (53%) and included corneal scarring (12/30), corneal neovascularization (6/30), conjunctivitis with or without granulation tissue formation (5/30), lipid keratopathy (1/30), and localized bullous keratopathy (2/30). Long-term side effects were reported in 6 of 30 cases (20%) cases and included deep scleral thinning (5/30), focal scleromalacia (3/30), globe perforation (2/30), lipid keratopathy (3/30), localized bullous keratopathy (1/30), and sectoral cortical cataract (1/30).
Lamellar resection and adjunctive 90Sr-beta plesiotherapy is relatively easy to perform, is minimally invasive, and extremely well tolerated by patients. The treatment is highly efficacious in the management of canine limbal melanoma. Modification of the radiation dosimetry, in particular reducing the total dose of radiation and the dose per radiation fraction, is necessary to reduce the incidence of late onset side effects.
评估板层切除术联合90Sr-β近距离治疗对犬角膜缘黑色素瘤的疗效以及治疗后早发和迟发副作用的发生率及发病情况。
回顾性研究。
1992年至2004年间在动物健康信托基金（AHT）接受角膜缘黑色素瘤治疗的30只犬。
查阅病历，收集所给予的辐射剂量、随访时间以及早发和迟发眼部副作用的发生率等信息。通过对患者进行复查或与转诊兽医或主人完成电话访谈来获取随访信息。
30例中有1例（3%；95%可信区间：0.2 - 14%）发生角膜缘黑色素瘤复发。30例中有16例（53%；95%可信区间：28.1 - 74.9%）出现一种或多种副作用。副作用的发生与治疗部位数量或总辐射表面剂量无关。16/30例（53%）报告有短期副作用，包括角膜瘢痕（12/30）、角膜新生血管（6/30）、伴有或不伴有肉芽组织形成的结膜炎（5/30）、脂质角膜病变（1/30）和局限性大疱性角膜病变（2/30）。30例中有6例（20%）报告有长期副作用，包括深层巩膜变薄（5/30）、局灶性巩膜软化（3/30）、眼球穿孔（2/30）、脂质角膜病变（3/30）、局限性大疱性角膜病变（1/30）和扇形皮质性白内障（1/30）。
板层切除术联合90Sr-β近距离治疗相对易于实施，微创，且患者耐受性极佳。该治疗方法在犬角膜缘黑色素瘤的管理中具有高效性。为降低迟发副作用的发生率，有必要调整辐射剂量测定法，特别是减少总辐射剂量和每次辐射剂量。
