Khetan Vikas, Gopal Lingam, Shanmugam Mahesh P, Gupta Aditi, Sharma Tarun, Bhende Pramod, Muthukumar Siva, Subramaniam R, Kuppuswamy Thayalan, Saxena S K, Dash Ashutosh
Department of Ocular Oncology and Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India, .
Indian J Ophthalmol. 2014 Feb;62(2):158-62. doi: 10.4103/0301-4738.128618.
To report our experience of brachytherapy using 'BARC I-125 Ocu-Prosta seeds' for the management of intraocular tumors with regard to tumor control, globe preservation visual outcome, and patient survival at Sankara Nethralaya, Chennai, India between September 2003 and May 2011.
We reviewed records of 35 eyes of 35 patients who underwent ophthalmic brachytherapy between September 2003 and May 2011. Twenty-one cases had choroidal melanoma, nine had childhood retinoblastoma, two had adult-onset retinoblastoma, and there were one case each of vasoproliferative tumor, retinal angioma, and ciliary body melanoma. Brachytherapy was administered using a 15- or 20-mm gold plaque with or without a notch. Brachytherapy was the primary treatment modality in all tumors other than retinoblastoma, wherein brachytherapy was done post chemoreduction for residual tumor.
For choroidal melanomas, the mean radiation dose was 68.69 ± 15.07 (range, 47.72-94.2) Gy. The eye salvage rate was 13/20 (65%) and tumor control rate was 16/20 (80%) at an average follow-up of 24.43 ± 24.75 (range, 1.5-87.98) months. For retinoblastoma, the mean dose was 45.85 ± 3.90 (range, 39.51-50.92) Gy. The eye salvage rate and tumor control rate was 5/6 (83.3%) at an average follow-up of 38.36 ± 31.33 (range, 4.14-97.78) months. All eyes with retinoblastoma needed additional focal therapy for tumor control and eye salvage.
The results of this retrospective study confirms that the use of 'BARC I-125 Ocu-Prosta seeds' in episcleral plaques to treat intraocular tumors offers a viable option for the management of intraocular cancers.
报告我们在印度钦奈桑卡拉奈特拉亚医院使用“巴罗克 I - 125 眼 - 前列腺籽源”进行近距离放射治疗眼内肿瘤的经验,内容涉及肿瘤控制、眼球保留、视觉预后及患者生存率,时间跨度为 2003 年 9 月至 2011 年 5 月。
我们回顾了 2003 年 9 月至 2011 年 5 月期间接受眼科近距离放射治疗的 35 例患者的 35 只眼的记录。其中 21 例为脉络膜黑色素瘤,9 例为儿童视网膜母细胞瘤,2 例为成人视网膜母细胞瘤,血管增生性肿瘤、视网膜血管瘤和睫状体黑色素瘤各 1 例。近距离放射治疗采用带或不带切口的 15 毫米或 20 毫米金质敷贴器。除视网膜母细胞瘤外,近距离放射治疗是所有肿瘤的主要治疗方式,视网膜母细胞瘤的近距离放射治疗在化疗减瘤后针对残留肿瘤进行。
对于脉络膜黑色素瘤,平均放射剂量为 68.69±15.07(范围 47.72 - 94.2)Gy。平均随访 24.43±24.75(范围 1.5 - 87.98)个月时,眼球挽救率为 13/20(65%),肿瘤控制率为 16/20(80%)。对于视网膜母细胞瘤,平均剂量为 45.85±3.90(范围 39.51 - 50.92)Gy。平均随访 38.36±31.33(范围 4.14 - 97.78)个月时,眼球挽救率和肿瘤控制率为 5/6(83.3%)。所有视网膜母细胞瘤患者的眼睛都需要额外的局部治疗以控制肿瘤和挽救眼球。
这项回顾性研究结果证实,在巩膜敷贴器中使用“巴罗克 I - 125 眼 - 前列腺籽源 ”治疗眼内肿瘤为眼内癌症的治疗提供了一种可行的选择。