Echegaray Jose J, Bechrakis Nikolaos E, Singh Nakul, Bellerive Claudine, Singh Arun D
Department of Ophthalmology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA.
Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria.
Ocul Oncol Pathol. 2017 Sep;3(3):193-198. doi: 10.1159/000455872. Epub 2017 Feb 8.
To investigate whether lower radiation doses may yield similar outcome measures to those from the COMS trial.
A literature review of English language articles was performed using the PubMed database of the U.S. National Library of Medicine and the Cochrane Central Register of Controlled Trials using the following keywords: uveal melanoma, choroidal melanoma, primary uveal malignant melanoma, iodine-125 brachytherapy, local recurrence, local treatment failure, and local tumor control. The relationships between study local recurrence rate and median dosage were tested by linear regression, with each study weighted by the number of patients included.
Fifteen retrospective and prospective studies were selected for systematic review (2,662 patients). Ranges of reported mean or median radiation dose to tumor apex were 62.5-104.0 Gy. Local recurrence rates ranged from 0 to 24%. A 1.0-Gy increase in the average study dose was associated with a 0.14% decrease in local recurrence rate, which was not statistically significant ( value 0.336).
The gold standard empirically derived 85.0-Gy radiation dose for the treatment of uveal melanoma could be tested in a randomized study.
研究较低辐射剂量是否能产生与COMS试验相似的结果指标。
使用美国国立医学图书馆的PubMed数据库和Cochrane对照试验中心注册库，对英文文章进行文献综述，使用以下关键词：葡萄膜黑色素瘤、脉络膜黑色素瘤、原发性葡萄膜恶性黑色素瘤、碘-125近距离放射治疗、局部复发、局部治疗失败和局部肿瘤控制。通过线性回归检验研究局部复发率与中位剂量之间的关系，每项研究按纳入患者数量加权。
选择了15项回顾性和前瞻性研究进行系统评价（2662例患者）。报道的肿瘤顶点平均或中位辐射剂量范围为62.5 - 104.0 Gy。局部复发率范围为0%至24%。研究平均剂量每增加1.0 Gy，局部复发率降低0.14%，但无统计学意义（P值0.336）。
可在一项随机研究中对经验得出的用于治疗葡萄膜黑色素瘤的85.0 Gy黄金标准辐射剂量进行检验。
