Romanowska-Dixon Bozena, Kowal Joanna, Pogrzebielski Arkadiusz, Markiewicz Anna
Z Katedry Okulistyki Uniwersytetu Jagiellońskiego Collegium Medium, Poland.
Klin Oczna. 2011;113(4-6):132-5.
Uveal metastases are the most common intraocular malignant tumors. Most patients who develop metastatic carcinoma to the choroid are managed by radiation or chemotherapy. Since TTT is an optional treatment for choroidal melanomas and hemangiomas, we ought to determine whether TIT is suitable for treatment of solitary choroidal metastasis at the posterior pole.
To evaluate effectivenes of TTT treatment for intraocular metastases.
45 patients (59 eyes) with intraocular metastases were treated in the Ophthalmological Department of Jagiellonian University in Kraków. There were 30 women and 15 man, at the age 31-84 years (av. 57.5). The primary tumor was a breast cancer in 22 women, lung cancer in 5 men and 2 women, kidney (3), colon (2), uterus (1), larynx (1), testicle (1), esophagus (1). 10 patients had also metastases in other organs. TTT was performed in all treated eyes, in 11 combined with 106Ru brachytherapy (BT). Chemotherapy as adjuvant treatment was performed in 18 patients. The results of treatment were evaluated in mean 14.5 months (1-61) follow-up.
After TTT, tumor shrinking was observed in most treated tumors (in 37 eyes, 62.7%), inhibition of tumor growth in 5 (8.4%), and in 4 cases (6.7%) progression of tumor growth. In 3 cases (5.1%) with flat scar and intraocular tumor shrinking, extrascleral extension located close to the tumor base appeared after treatment (TTT in 2 eyes, TTT combined with BT in one case).
TTT is an effective treatment method for small choroidal metastases located in the posterior pole. TTT combined with 106Ru brachytherapy can be useful treatment in medium sized choroidal metastases. Efficient results encourage further application of thermotherapy in the treatment of intraocular metastases. It allows for the conservative treatment of the eyeball and also useful visual acuity. Extraocular extension appearing after TT needs further study.
葡萄膜转移瘤是最常见的眼内恶性肿瘤。大多数发生脉络膜转移癌的患者采用放疗或化疗进行治疗。由于TTT是脉络膜黑色素瘤和血管瘤的一种可选治疗方法，我们应该确定TTT是否适用于治疗后极部孤立性脉络膜转移瘤。
评估TTT治疗眼内转移瘤的有效性。
克拉科夫雅盖隆大学眼科对45例（59只眼）眼内转移瘤患者进行了治疗。其中女性30例，男性15例，年龄31 - 84岁（平均57.5岁）。原发肿瘤为乳腺癌的女性有22例，肺癌的男性5例、女性2例，肾癌（3例）、结肠癌（2例）、子宫癌（1例）、喉癌（1例）、睾丸癌（1例）、食管癌（1例）。10例患者还伴有其他器官转移。所有治疗眼均进行了TTT，其中11例联合106Ru近距离放疗（BT）。18例患者进行了化疗作为辅助治疗。在平均14.5个月（1 - 61个月）的随访中评估治疗结果。
TTT治疗后观察到，大多数治疗的肿瘤出现缩小（37只眼，62.7%），5只眼（8.4%）肿瘤生长受到抑制，4例（6.7%）肿瘤生长进展。3例（5.1%）出现扁平瘢痕且眼内肿瘤缩小的患者，治疗后在靠近肿瘤基底处出现巩膜外扩展（2只眼行TTT，1例为TTT联合BT）。
TTT是治疗位于后极部的小脉络膜转移瘤的有效治疗方法。TTT联合106Ru近距离放疗对中等大小的脉络膜转移瘤可能是有效的治疗方法。有效结果鼓励进一步将热疗应用于眼内转移瘤的治疗。它允许对眼球进行保守治疗并保持有用的视力。TT后出现的巩膜外扩展需要进一步研究。
