Agraval Umiya, Sobti Manvi, Russell Heather C, Lockington David, Ritchie Diana, Cauchi Paul, Kemp Ewan G, Chadha Vikas
Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.
Oncology, Beatson West of Scotland Cancer Center, Glasgow, UK.
Br J Ophthalmol. 2018 Jan;102(1):74-78. doi: 10.1136/bjophthalmol-2017-310278. Epub 2017 Jun 9.
To analyse long-term outcomes of ruthenium-106 (Ru) plaque brachytherapy for the treatment of iris melanoma.
We retrospectively reviewed medical records of 19 consecutive patients with pure iris melanoma treated with Ru plaque brachytherapy between 1998 and 2016 at the Scottish Ophthalmic Oncology Service, Glasgow. The iris melanoma was treated with a ruthenium plaque placed on the corneal surface to deliver a surface dose of 555 Gy. We analysed vision preservation, local tumour control, radiation-related complications, eye retention rates, symptomatic metastasis and melanoma-related mortality.
The mean largest basal diameter of the lesions was 3.50±1.42 mm (range 1.6-6.5 mm), and the mean maximum height was 1.47±0.65 mm (range 0.7-2.8 mm). The tumour control and eye retention were 100% at a mean follow-up of 62 months (range 6-195 months). A 62% reduction in tumour height was observed on ultrasonography. Complications included cataract (68%), dry eye (47%), uveitis (37%) and scleral thinning (5%). At the final follow-up visit, the mean loss of Snellen visual acuity was 1.11±2.90 lines and vision of 6/9 or better was maintained in 53% of patients. None of the patients had evidence of symptomatic metastasis (non-imaged) or melanoma-related mortality.
Ru plaque treatment for iris melanoma was highly effective a high tumour control, no tumour recurrences and a relatively a low complication rate.
分析106钌（Ru）敷贴近距离放射治疗虹膜黑色素瘤的长期疗效。
我们回顾性分析了1998年至2016年间在格拉斯哥苏格兰眼科肿瘤服务中心接受Ru敷贴近距离放射治疗的19例单纯虹膜黑色素瘤患者的病历。虹膜黑色素瘤采用放置在角膜表面的钌敷贴进行治疗，表面剂量为555 Gy。我们分析了视力保留情况、局部肿瘤控制情况、放射相关并发症、眼球保留率、有症状转移情况以及黑色素瘤相关死亡率。
病变的平均最大基底直径为3.50±1.42毫米（范围1.6 - 6.5毫米），平均最大高度为1.47±0.65毫米（范围0.7 - 2.8毫米）。平均随访62个月（范围6 - 195个月）时，肿瘤控制率和眼球保留率均为100%。超声检查显示肿瘤高度降低了62%。并发症包括白内障（68%）、干眼（47%）、葡萄膜炎（37%）和巩膜变薄（5%）。在最后一次随访时，Snellen视力平均下降1.11±2.90行，53%的患者视力保持在6/9或更好。所有患者均无有症状转移（未成像）或黑色素瘤相关死亡的证据。
Ru敷贴治疗虹膜黑色素瘤具有高效性，肿瘤控制良好，无肿瘤复发，并发症发生率相对较低。
