Isohashi Fumiaki, Inoue Takehiro, Xing Shuo, Eren Cetin Bekir, Ozeki Shuji, Inoue Toshihiko
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan.
Strahlenther Onkol. 2006 Aug;182(8):437-42. doi: 10.1007/s00066-006-1484-1.
Irradiation of ocular pterygium is considered a valuable treatment supplementation after surgical therapy. Since prospective randomized trials are scare and only limited patient data are available, the aim of this study was to evaluate the patient population treated with fractioned 90Sr irradiation after surgical pterygium resection.
Between September 1993 and March 2001, 1,147 patients with pterygium lesions (1,320 lesions) were treated surgically and with 90Sr postoperative beta-irradiation. A total dose of 30 Gy was used for patients treated within 48 h after surgery, while those treated>48 h postoperatively received a total dose of 35 Gy. A minimum follow-up period of 3 months was required for inclusion in the analysis, and 1,253 lesions were ultimately analyzed.
Recurrence of the pterygium after postoperative 90Sr irradiation was observed in 97 of 1,253 cases (7.7%). Statistical analysis (uni- and multivariate) revealed, that male gender, younger age (<40 years), prior treatment (surgery and radiotherapy) and immediate irradiation (<2 h after surgery) were negative predictors for local recurrence. Temporary radiotherapy-induced side effects were observed in 15.2% of patients, including moderate conjunctivitis, local pain, visual disturbance and photophobia or an increase in tear flow. However, no long-term serious side effects were documented.
90Sr irradiation of pterygium after surgery represents a safe and effective treatment option to prevent disease recurrence. The data obtained in this study indicate that a certain interval after surgery might improve therapy outcome.
眼部翼状胬肉的放射治疗被认为是手术治疗后一种有价值的辅助治疗方法。由于前瞻性随机试验较少，且仅有有限的患者数据，本研究的目的是评估翼状胬肉切除术后接受分次90锶放射治疗的患者群体。
1993年9月至2001年3月期间，1147例患有翼状胬肉病变（1320处病变）的患者接受了手术及术后90锶β射线照射治疗。术后48小时内接受治疗的患者总剂量为30 Gy，而术后超过48小时接受治疗的患者总剂量为35 Gy。纳入分析要求最短随访期为3个月，最终分析了1253处病变。
1253例病例中有97例（7.7%）在术后90锶照射后出现翼状胬肉复发。统计分析（单因素和多因素）显示，男性、年龄较小（<40岁）、既往治疗（手术和放疗）以及即刻照射（术后<2小时）是局部复发的负性预测因素。15.2%的患者出现了放疗引起的暂时性副作用，包括中度结膜炎、局部疼痛、视力障碍、畏光或泪液分泌增加。然而，未记录到长期严重副作用。
术后90锶照射翼状胬肉是预防疾病复发的一种安全有效的治疗选择。本研究获得的数据表明，术后一定的间隔时间可能会改善治疗效果。
