Shildkrot Yevgeniy, Wilson Matthew W
Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
Curr Opin Ophthalmol. 2009 Nov;20(6):504-10. doi: 10.1097/ICU.0b013e328330b549.
The current treatment options for posterior uveal melanoma and its metastases are reviewed in this paper. Recent developments in understanding genetic and molecular features of these tumors are discussed with emphasis on clinical application.
The management of uveal melanomas has shifted to more eye-sparing approaches without significant improvement in patient survival. There has been an increased understanding of the genetic and molecular abnormalities that lead to melanomas that are more likely to metastasize. Treatments of metastatic disease remain inadequate.
Uveal melanoma appears to be a systemic disease at presentation. Treatment of the primary disease may be curative in some patients. However, up to 50% of patients will ultimately succumb to the metastatic disease. The accuracy of patient prognostication can be enhanced by tumor cytogenetics. Even with this knowledge, no effective adjuvant treatments exist. Further research and innovation will allow tailored therapies for patients with high-risk tumor features.
本文对后葡萄膜黑色素瘤及其转移灶的当前治疗选择进行综述。重点讨论了在理解这些肿瘤的遗传和分子特征方面的最新进展及其临床应用。
葡萄膜黑色素瘤的治疗已转向更具保眼性的方法，但患者生存率并未显著提高。人们对导致更易发生转移的黑色素瘤的遗传和分子异常有了更多了解。转移性疾病的治疗仍然不足。
葡萄膜黑色素瘤在发病时似乎是一种全身性疾病。对原发性疾病的治疗在某些患者中可能治愈。然而，高达50%的患者最终会死于转移性疾病。肿瘤细胞遗传学可提高患者预后预测的准确性。即便有了这些知识，仍不存在有效的辅助治疗方法。进一步的研究和创新将为具有高危肿瘤特征的患者提供量身定制的治疗方法。
