Damato Bertil E
Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, UK.
Dev Ophthalmol. 2012;49:16-26. doi: 10.1159/000328251. Epub 2011 Oct 21.
Uveal melanomas can be treated by various forms and combinations of radiotherapy, phototherapy and local resection, which need to be tailored to the tumour size, location and extent as well as the patient's needs, fears and wishes. Many factors complicate the process of treatment selection and these include limited resources, incomplete knowledge of the patient's condition (e.g. genetic tumour type) and inadequate scientific evidence on which to base decision making. In this chapter, I describe how I select treatment for small, large, juxtapapillary, ciliary and iridal melanomas, respectively, and for melanocytic tumours of indeterminate malignancy. I also describe how I interact with patients so as to select the most suitable treatment in a personalised manner. Finally, I discuss challenges and shortcomings in this aspect of patient care, also providing suggestions for further research in this field.
葡萄膜黑色素瘤可以通过放疗、光疗和局部切除等多种形式及联合方式进行治疗,这些治疗方式需要根据肿瘤大小、位置、范围以及患者的需求、恐惧和意愿进行调整。许多因素使治疗选择过程变得复杂,其中包括资源有限、对患者病情的了解不完整(如肿瘤基因类型)以及缺乏用于决策的充分科学证据。在本章中,我将分别描述我如何为小型、大型、近乳头、睫状体和虹膜黑色素瘤以及恶性程度不确定的黑素细胞肿瘤选择治疗方法。我还将描述我如何与患者互动,以便以个性化的方式选择最合适的治疗方法。最后,我将讨论在这方面患者护理中的挑战和不足,并为该领域的进一步研究提供建议。