Riva Giulia, Augugliaro Matteo, Piperno Gaia, Ferrari Annamaria, Rondi Elena, Vigorito Sabrina, Ciardo Delia, Orecchia Roberto, Jereczek-Fossa Barbara Alicja
1 Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.
2 Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
Eur J Ophthalmol. 2019 Jan;29(1):61-68. doi: 10.1177/1120672118761728. Epub 2018 Mar 27.
: To evaluate the feasibility, in terms of acute toxicity and symptom control, of CyberKnife (Accuray, Sunnyvale, CA)-based stereotactic radiotherapy (CyberKnife-SRT) for metastatic orbital lesions.
: This retrospective study included patients with symptomatic metastases wholly located within the orbit. Palliative radiation treatment was performed using CyberKnife image-guided technology. Gross tumor volume was defined on a pre-radiotherapy magnetic resonance imaging. Acute and late toxicity was recorded according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Scale.
: Between April 2012 and July 2016, 21 patients underwent CyberKnife-SRT for 24 orbital metastases from different primary tumors. Median treatment dose was 18 Gy (15-24 Gy) given in a median of 3 fractions (2-3 fractions) with a median dose of 6 Gy/fraction (5-10 Gy/fraction). Acute grade 1 toxicity was observed in eight cases. No local recurrence occurred after median follow-up of 6.2 months (1.1-30.0 months) among 16 lesions that underwent post-stereotactic radiotherapy magnetic resonance imaging. All patients reported decreasing pre-stereotactic radiotherapy symptoms without late toxicity. Follow-up >6 months (median 22.8 months) was available for nine lesions; complete and partial radiological response was registered in four and five of them, respectively.
: In our experience, CyberKnife-SRT is a well-tolerated treatment that offers high local and symptom control in patients with intraocular and periocular malignant lesions.
从急性毒性和症状控制方面评估基于射波刀（Accuray公司，加利福尼亚州桑尼维尔）的立体定向放射治疗（射波刀立体定向放射治疗）用于转移性眼眶病变的可行性。
这项回顾性研究纳入了症状性转移灶完全位于眼眶内的患者。使用射波刀图像引导技术进行姑息性放射治疗。在放疗前的磁共振成像上定义大体肿瘤体积。根据放射治疗肿瘤学组/欧洲癌症研究与治疗组织标准记录急性和晚期毒性。
2012年4月至2016年7月期间，21例患者因来自不同原发肿瘤的24个眼眶转移灶接受了射波刀立体定向放射治疗。中位治疗剂量为18 Gy（15 - 24 Gy），中位分3次给予（2 - 3次），中位剂量为6 Gy/次（5 - 10 Gy/次）。8例观察到急性1级毒性。在16个接受立体定向放射治疗后磁共振成像的病灶中，中位随访6.2个月（1.1 - 30.0个月）后未发生局部复发。所有患者均报告立体定向放射治疗前的症状减轻，且无晚期毒性。9个病灶有>6个月（中位22.8个月）的随访；其中4个和5个分别记录到完全和部分影像学缓解。
根据我们的经验，射波刀立体定向放射治疗耐受性良好，可为眼内和眼周恶性病变患者提供较高的局部控制率和症状控制。
