Ocular Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada.
Can J Ophthalmol. 2011 Apr;46(2):158-63. doi: 10.3129/i10-111.
To report the host, tumour, and radiation-related predictive factors for developing radiation retinopathy post (125)Iodine brachytherapy for uveal melanoma.
A retrospective clinical case series.
Three hundred consecutive patients with uveal melanoma treated with (125)Iodine brachytherapy.
Electronic chart review of demographic, clinical, treatment, and follow-up data. Proliferative and (or) nonproliferative radiation retinopathy patients were included. Cumulative incidence rates were calculated using Kaplan-Meier estimates. Univariate and multivariate statistical regression analyses were performed to identify factors predictive of radiation retinopathy.
The mean follow-up period was 48 months. Radiation retinopathy occurred in 107 patients (36%). Actuarial incidence of radiation retinopathy was 30% (CI 24%-36%) at 24 months post-treatment. In the multivariate model, the predictive factors were a younger age (hazard ratio [HR] 0.98, p < 0.03), diabetes (HR 2.17, p < 0.007), and hypertension (HR 2.17, p < 0.004). Tumour-related factors were proximity to optic disc (HR 0.95, p < 0.02) and proximity to foveola (HR 0.96, p < 0.02). Pretreatment tumour dimensions, other tumour characteristics, and total radiation dose did not demonstrate statistically significant risks for developing radiation retinopathy.
Radiation retinopathy affects 30% of patients 2 years following (125)Iodine brachytherapy for uveal melanoma. The predictive factors for radiation retinopathy are a younger age, comorbidity with diabetes or hypertension, and proximity of the tumour margin to the optic disc or foveola. Identifying the predictive factors for developing radiation retinopathy can modify follow-up for patients at risk, which may permit earlier management of the developing radiation-induced ischemic retinal changes.
报告与宿主、肿瘤和放射相关的预测因素，以预测放射性视网膜病变的发生，这些病变发生在脉络膜黑色素瘤接受（125）碘近距离放射治疗后。
回顾性临床病例系列。
300 例连续接受（125）碘近距离放射治疗的脉络膜黑色素瘤患者。
电子病历回顾了人口统计学、临床、治疗和随访数据。纳入了增殖性和（或）非增殖性放射性视网膜病变患者。使用 Kaplan-Meier 估计计算累积发生率。进行单变量和多变量统计回归分析，以确定放射性视网膜病变的预测因素。
平均随访时间为 48 个月。107 例（36%）患者发生放射性视网膜病变。治疗后 24 个月放射性视网膜病变的实际发生率为 30%（CI 24%-36%）。在多变量模型中，预测因素是年龄较小（风险比 [HR] 0.98，p < 0.03）、糖尿病（HR 2.17，p < 0.007）和高血压（HR 2.17，p < 0.004）。肿瘤相关因素是靠近视盘（HR 0.95，p < 0.02）和靠近黄斑中心凹（HR 0.96，p < 0.02）。治疗前肿瘤尺寸、其他肿瘤特征和总放射剂量与放射性视网膜病变的发生无显著统计学风险相关。
放射性视网膜病变影响 30%的脉络膜黑色素瘤患者在接受（125）碘近距离放射治疗后 2 年。放射性视网膜病变的预测因素是年龄较小、合并糖尿病或高血压、肿瘤边缘与视盘或黄斑中心凹的距离。确定发生放射性视网膜病变的预测因素可以改变高危患者的随访方式，这可能允许更早地管理正在发生的放射性缺血性视网膜改变。
