Tsai Yi-Chieh, Kuo Chun-Yuan, Lin Jia-Wei, Yang Shun-Tai, Lai Shih-Chung, Tsai Jo-Ting
Department of Radiation Oncology, Taipei Medical University - Shuang Ho Hospital, New Taipei, Taiwan 23561, R.O.C.
Department of Medical Imaging and Radiological Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan 30015, R.O.C.
Oncol Lett. 2018 Jan;15(1):91-98. doi: 10.3892/ol.2017.7300. Epub 2017 Oct 31.
Radiosurgery serves an important function in the treatment of patients with intraocular tumors and preserves visual function via organ conservation. Therefore, it is important to ensure the safety and precision of GK-SRS as a primary treatment for intraocular tumors. The present case study described a 57-year-old female with uveal melanoma treated with GK-SRS. Retrobulbar anesthesia following fixation of the treated eye, via the suture of two of the extraocular muscles to the stereotactic frame, was performed to immobilize the eye during treatment. Computed tomography (CT) scans were performed following eye fixation, immediately prior to and following GK-SRS, to validate the accuracy of the tumor localization. The eye movement analysis revealed that the gravity center point deviations of the tumor and lens during treatment were <0.110 mm. At least 95% of the tumor volume was covered by the prescription dose according to three sets of CT images. The patient underwent a trans pars plana vitrectomy owing to a right eye vitreous hemorrhage. A 37-month follow-up assessment revealed tumor shrinkage, and the disappearance of the serous retinal detachments was noted on the basis of ophthalmoscopy and orbital magnetic resonance imaging. No major complications developed during the follow-up period. Using our treatment protocol, GK-SRS is a non-invasive procedure which is used as a brief single fraction treatment for intraocular tumor. The eye fixation method used in the present study has high accuracy.
立体定向放射外科在眼内肿瘤患者的治疗中发挥着重要作用，通过器官保留来维持视觉功能。因此，确保伽玛刀立体定向放射外科（GK-SRS）作为眼内肿瘤主要治疗方法的安全性和精确性至关重要。本病例研究描述了一名57岁患有葡萄膜黑色素瘤的女性接受GK-SRS治疗的情况。通过将两条眼外肌缝合到立体定向框架上固定治疗眼后，进行球后麻醉，以便在治疗期间固定眼球。在眼球固定后、GK-SRS治疗前及治疗后立即进行计算机断层扫描（CT），以验证肿瘤定位的准确性。眼球运动分析显示，治疗期间肿瘤和晶状体的重心点偏差<0.110毫米。根据三组CT图像，至少95%的肿瘤体积被处方剂量覆盖。由于右眼玻璃体积血，患者接受了经平坦部玻璃体切除术。37个月的随访评估显示肿瘤缩小，根据眼底镜检查和眼眶磁共振成像观察到浆液性视网膜脱离消失。随访期间未出现重大并发症。采用我们的治疗方案，GK-SRS是一种非侵入性手术，用作眼内肿瘤的单次简短治疗。本研究中使用的眼球固定方法具有很高的准确性。
