Damato Bertil, Kacperek Andrzej, Errington Doug, Heimann Heinrich
Ocular Oncology Service, Departments of Ophthalmology and Radiation Oncology, University of California, San Francisco, United States ; Ocular Oncology Service, Royal Liverpool University Hospital, United Kingdom ; Douglas Cyclotron Unit, Clatterbridge Cancer Centre, United Kingdom.
Saudi J Ophthalmol. 2013 Jul;27(3):151-7. doi: 10.1016/j.sjopt.2013.06.014.
Proton beam radiotherapy of uveal melanoma can be administered as primary treatment, as salvage therapy for recurrent tumor, and as neoadjuvant therapy prior to surgical resection. The physical properties of proton beams make it possible to deliver high-doses of radiation to the tumor with relative sparing of adjacent tissues. This form of therapy is effective for a wider range of uveal melanoma than any other modality, providing exceptionally-high rates of local tumor control. This is particularly the case with diffuse iris melanomas, many of which are unresectable. The chances of survival, ocular conservation, visual preservation and avoidance of iatrogenic morbidity depend greatly on the tumor size, location and extent. When treating any side-effects and/or complications, it is helpful to consider whether these are the result of collateral damage or persistence of the irradiated tumor ('toxic tumor syndrome').
葡萄膜黑色素瘤的质子束放射治疗可作为主要治疗方法、复发性肿瘤的挽救性治疗以及手术切除前的新辅助治疗。质子束的物理特性使得在相对 sparing 相邻组织的情况下，能够向肿瘤输送高剂量的辐射。这种治疗形式对更广泛的葡萄膜黑色素瘤有效，比任何其他治疗方式都能提供极高的局部肿瘤控制率。弥漫性虹膜黑色素瘤尤其如此，其中许多是无法切除的。生存、眼球保留、视力保留以及避免医源性发病率的机会在很大程度上取决于肿瘤的大小、位置和范围。在治疗任何副作用和/或并发症时，考虑这些是附带损伤还是受照射肿瘤持续存在（“毒性肿瘤综合征”）的结果会有所帮助。 （注：原文中“sparing”可能有误，推测可能是“sparing of”，表示“对……的 sparing”，这里暂按原文翻译）
