Department of Ophthalmology and Melanoma Center, Leiden University Medical Center, Leiden, The Netherlands.
Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands.
Br J Ophthalmol. 2018 Aug;102(8):1154-1159. doi: 10.1136/bjophthalmol-2017-310688. Epub 2017 Nov 9.
To evaluate ruthenium-106 (Ru106) brachytherapy as eye-conserving treatment of iris melanomas (IMs) and iridociliary melanomas (ICMs).
Eighty-eight patients received Ru106 brachytherapy between 2006 and 2016. Primary outcome was local control, and secondary outcomes were metastasis, survival, eye preservation, complications and visual acuity (VA).
Overall median follow-up was 36 months. Of 88 patients, 58 (65.9%) had IM and 30 (34.1%) had ICM. ICM were on average larger and more advanced than IM. Local failure-free survival at 3years was 98.9% (SE 1.2%). Metastasis-free survival was 98.2% (SE 1.8%) at 3years; no deaths due to melanoma occurred during follow-up. Eye preservation rate was 97.7%. Treatment-related toxicities were mostly mild and observed in 80.7% of the patients. Common toxicities were worsening of pre-existing or new cataract (51.1%), dry eyes (29.5%) and glaucoma (20.5%). VA was not affected by Ru106 brachytherapy, with only 2.3% having VA <0.33 (low vision) at follow-up.
Ru106 for IM and ICM yielded excellent local control (98.9%) and eye preservation (97.7%). Toxicities were common, but mostly mild and transient. Moreover, Ru106 did not affect visual acuity.
评估钌-106（Ru106）近距离放疗作为虹膜黑色素瘤（IM）和睫状体黑色素瘤（ICM）的保眼治疗方法。
2006 年至 2016 年间，88 例患者接受了 Ru106 近距离放疗。主要结局为局部控制，次要结局为转移、生存、保眼、并发症和视力（VA）。
88 例患者的中位随访时间为 36 个月。58 例（65.9%）为 IM，30 例（34.1%）为 ICM。ICM 比 IM 更大且更晚期。3 年局部无失败生存率为 98.9%（SE 1.2%）。3 年无转移生存率为 98.2%（SE 1.8%）；随访期间无黑色素瘤死亡病例。保眼率为 97.7%。治疗相关毒性大多为轻度，见于 80.7%的患者。常见的毒性有原有或新发白内障加重（51.1%）、干眼症（29.5%）和青光眼（20.5%）。VA 不受 Ru106 近距离放疗的影响，仅有 2.3%的患者在随访时 VA<0.33（低视力）。
Ru106 治疗 IM 和 ICM 可获得优异的局部控制（98.9%）和保眼效果（97.7%）。毒性常见，但大多为轻度和短暂的。此外，Ru106 不会影响视力。
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