Schelhorn Juliane, Richly Heike, Ruhlmann Marcus, Lauenstein Thomas C, Theysohn Jens M
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany.
Department of Hematology und Oncology, University Hospital Essen, Essen, Germany.
Acta Radiol Open. 2015 Apr 6;4(4):2047981615570417. doi: 10.1177/2047981615570417. eCollection 2015 Apr.
Overall survival (OS) of patients with hepatic metastases of uveal melanoma is strongly linked with hepatic tumor control. Due to the lack of an effective systemic chemotherapy, locoregional therapies like radioembolization should play an increasingly important role.
To report complications and response rates of radioembolization as salvage therapy for hepatic uveal melanoma metastases.
Between October 2006 and January 2014, eight patients (age, 59.1 ± 15.3 years; 5 men) with histologically proven uveal melanoma and hepatic metastases received radioembolization with glass microspheres at a single center. All patients had been heavily pretreated with multiple systemic/locoregional therapies resulting in a long median interval between diagnosis of hepatic metastases and radioembolization (17.1 months; range, 6.4-23.2 months). Follow-up consisted of clinical assessment, laboratory tests and tri-phasic computed tomography (CT) before and 1, 3, 6, 9, and 12 months after radioembolization. Response to therapy was evaluated by CT using RECIST version 1.1 and by survival time. Safety (laboratory and clinical toxicity) was rated according to Common Terminology Criteria for Adverse Events 4.03. Using Kaplan-Meier analysis time to progression of hepatic metastases (hTTP) and OS were calculated.
One month after radioembolization 50% of patients presented with stable and 50% with progressive disease. Median hTTP and OS after radioembolization were 4.3 weeks (range, 3.4-28.6 weeks) and 12.3 weeks (range, 3.7-62.6 weeks), respectively. Median OS after diagnosis of hepatic metastases was 19.9 months (range, 7.3-31.4 months). Radioembolization was tolerated well in all patients without toxicity higher than grade 2.
Radioembolization is a safe salvage therapy even in heavily pretreated hepatic metastases of uveal melanoma.
葡萄膜黑色素瘤肝转移患者的总生存期（OS）与肝脏肿瘤控制密切相关。由于缺乏有效的全身化疗，像放射性栓塞这样的局部区域治疗应发挥越来越重要的作用。
报告放射性栓塞作为葡萄膜黑色素瘤肝转移挽救治疗的并发症和缓解率。
2006年10月至2014年1月期间，8例经组织学证实为葡萄膜黑色素瘤且有肝转移的患者（年龄59.1±15.3岁；5例男性）在单一中心接受了玻璃微球放射性栓塞治疗。所有患者均接受过多种全身/局部区域治疗的大量预处理，导致肝转移诊断与放射性栓塞之间的中位间隔时间较长（17.1个月；范围6.4 - 23.2个月）。随访包括临床评估、实验室检查以及放射性栓塞前、栓塞后1、3、6、9和12个月的三期计算机断层扫描（CT）。通过使用RECIST 1.1版的CT和生存时间评估治疗反应。根据不良事件通用术语标准4.03对安全性（实验室和临床毒性）进行评级。使用Kaplan - Meier分析计算肝转移进展时间（hTTP）和OS。
放射性栓塞后1个月，50%的患者病情稳定，50%的患者病情进展。放射性栓塞后的中位hTTP和OS分别为4.3周（范围3.4 - 28.6周）和12.3周（范围3.7 - 62.6周）。肝转移诊断后的中位OS为19.9个月（范围7.3 - 31.4个月）。所有患者对放射性栓塞耐受性良好，无高于2级的毒性。
即使对于接受过大量预处理的葡萄膜黑色素瘤肝转移患者，放射性栓塞也是一种安全的挽救治疗方法。
