Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, Mersey, UK.
Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, Mersey, UK.
Br J Ophthalmol. 2014 Jul;98(7):967-71. doi: 10.1136/bjophthalmol-2013-304472. Epub 2014 Feb 11.
To determine the reduction of choroidal melanoma thickness 6 months after ruthenium 106-brachytherapy according to chromosome 3 status, which correlates strongly with metastatic death.
Transscleral fine needle aspiration biopsy was performed prior to the insertion of a radioactive plaque if the tumour was deemed sufficiently thick and anterior for such a procedure. Transretinal biopsy with a 25-gauge vitreous cutter was performed for thin and posterior tumour within a month of plaque removal. The chromosome 3 status was determined by fluorescence in situ hybridisation from 2002 until 2006, and by either multiplex ligation-dependent probe amplification and/or microsatellite analysis after this period until the end of the study. The choroidal melanoma dimensions were obtained from outpatient visits.
149 eyes from 149 patients were included. The mean age was 60.8 years. 84 eyes (56.4%) had disomy 3 and 65 eyes (43.6%) monosomy 3. The median pretreatment tumour thickness was 3.0 mm in disomy 3 and 4.1 mm in monosomy 3 tumours (p=0.018). The follow-up duration medians were 6.3 months for disomy 3 and 6.4 months for monosomy 3 tumours (p=0.68). The rates of thickness reduction were 6.7% and 7.0% per month, respectively (p=0.59). Thickness reduction exceeding 50% occurred in 32 (38.1%) disomy 3 and 24 (36.9%) monosomy 3 tumours.
The rate of choroidal melanoma regression after ruthenium-106 brachytherapy does not appear to correlate with chromosome 3 loss, suggesting that tumour thickness reduction 6 months after treatment is unlikely to predict survival.
根据与转移死亡密切相关的染色体 3 状态，确定钌 106 近距离放疗后 6 个月脉络膜黑色素瘤厚度的减少。
如果肿瘤足够厚且靠前，适合进行此手术，则在插入放射性贴剂之前进行经巩膜细针抽吸活检。对于在贴剂去除后一个月内的薄而靠后的肿瘤，进行 25G 玻璃体切割器经视网膜活检。从 2002 年到 2006 年，通过荧光原位杂交确定染色体 3 状态，在此之后，通过多重连接依赖性探针扩增和/或微卫星分析确定染色体 3 状态，直到研究结束。脉络膜黑色素瘤的尺寸是从门诊就诊中获得的。
纳入了 149 名患者的 149 只眼。平均年龄为 60.8 岁。84 只眼（56.4%）存在染色体 3 二倍体，65 只眼（43.6%）存在染色体 3 单体。二倍体 3 肿瘤的预处理肿瘤厚度中位数为 3.0mm，单体 3 肿瘤为 4.1mm（p=0.018）。二倍体 3 肿瘤的随访时间中位数为 6.3 个月，单体 3 肿瘤为 6.4 个月（p=0.68）。厚度减少率分别为每月 6.7%和 7.0%（p=0.59）。厚度减少超过 50%的情况分别发生在 32 只（38.1%）二倍体 3 肿瘤和 24 只（36.9%）单体 3 肿瘤中。
钌 106 近距离放疗后脉络膜黑色素瘤消退的速度似乎与染色体 3 缺失无关，这表明治疗后 6 个月的肿瘤厚度减少不太可能预测生存。
