Rotman M, Long R S, Packer S, Moroson H, Galin M A, Chan B
Trans Ophthalmol Soc U K (1962). 1977 Sep;97(3):431-5.
During the past 8 years, 32 patients with melanoma of the choroid have been treated with cobalt-60 ophthalmic applicators. Excluding three patients lost to follow-up, 24 patients who have now been observed for at least 3 years after treatment form the subject of this study. Each application but two delivered 8,500 to 10,000 rads to the tumour apex. A second application was performed in large tumours showing a poor response to the initial plaque treatment. The factors affecting results include age of the patient, tumour size, total dose delivered, and dose rate. Three out of seventeen patients with tumour diameters greater than 12 mm died of their disease with pulmonary and/or liver metastasis. Three eyes required enucleation and no residual tumour was found in two specimens. Three patients, average age 76 years, died from causes other than melanoma. An 83 per cent relative survival, excluding the three patients lost to follow-up, compares favourably with enucleation. The low incidence of metastasis after radiotherapy suggests augmentation and/or continuation of the host's immune response. Low energy radiation using Iodine-125, with its unusual protective characteristics is ideal for treatment of choroidal melanoma.
在过去8年中，32例脉络膜黑色素瘤患者接受了钴 - 60眼科敷贴器治疗。除3例失访患者外，24例患者在治疗后已被观察至少3年，构成了本研究的对象。除两次外，每次敷贴均向肿瘤顶端给予8500至10000拉德的剂量。对于对初始斑块治疗反应不佳的大肿瘤进行了第二次敷贴。影响结果的因素包括患者年龄、肿瘤大小、给予的总剂量和剂量率。17例肿瘤直径大于12毫米的患者中有3例因疾病伴肺和/或肝转移死亡。3只眼需要眼球摘除，在两个标本中未发现残留肿瘤。3例平均年龄76岁的患者死于黑色素瘤以外的原因。排除3例失访患者后，83%的相对生存率与眼球摘除术相比具有优势。放疗后转移发生率低提示宿主免疫反应增强和/或持续存在。使用碘 - 125的低能辐射具有独特的保护特性，是治疗脉络膜黑色素瘤的理想选择。
