a Department of Oncology , Comprehensive Cancer Centre, University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
b Department of Radiology, HUS Medical Imaging Centre , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
Acta Oncol. 2018 Oct;57(10):1373-1380. doi: 10.1080/0284186X.2018.1465587. Epub 2018 Apr 23.
In Finland, selective internal radiation therapy (SIRT) is at present the preferred first-line loco-regional therapy for uveal melanoma patients with hepatic metastases not suitable for surgery. We retrospectively evaluate the outcome and safety of SIRT in this group of patients.
Yttrium-90 microspheres were delivered via the hepatic artery into the circulation of metastases from uveal melanoma in 18 patients with a predicted life expectancy of more than three months in three Finnish tertiary referral centers between November 2010 and December 2015. Progression-free survival (PFS), toxicity and overall survival (OS) were evaluated. Patients with historical uveal melanoma without extrahepatic metastases, who had received systemic chemotherapy as first-line treatment for their hepatic metastases at the Helsinki University Hospital between January 2006 and May 2010, were used as a historical control group.
Partial response and stable disease were observed in three (17%) and eight (44%) patients, respectively; one patient was not evaluable for response. Median PFS after SIRT was 5.6 (range, 1.3-40.8) months. Median OS after SIRT was 13.5 (range, 3.6-44.8) months compared with 10.5 (range, 3.0-16.5; p = .047) months for the historical chemotherapy group. Among patients who received SIRT as first-line treatment, the median OS was 18.7 (range, 8.2-44.8) months, significantly longer than that of the chemotherapy group (10.5 months, p = .017). There were no treatment-related deaths. Toxicity was mainly WHO grade 1-2 and self-limited.
SIRT is a feasible and safe treatment for liver metastases in patients with uveal melanoma.
在芬兰，选择性内部放射治疗（SIRT）目前是不适合手术的肝转移患者首选的局部区域一线治疗方法。我们回顾性评估了该组患者 SIRT 的结果和安全性。
2010 年 11 月至 2015 年 12 月，在芬兰的三个三级转诊中心，18 例预期寿命超过三个月的患者，通过肝动脉将钇-90 微球输送至眼黑色素瘤转移的循环中。评估无进展生存期（PFS）、毒性和总生存期（OS）。使用历史上无肝外转移的眼黑色素瘤患者作为对照组，这些患者在 2006 年 1 月至 2010 年 5 月期间在赫尔辛基大学医院接受了系统化疗作为肝转移的一线治疗。
3 例（17%）和 8 例（44%）患者分别观察到部分缓解和稳定疾病；1 例患者无法评估反应。SIRT 后的中位 PFS 为 5.6（范围 1.3-40.8）个月。SIRT 后的中位 OS 为 13.5（范围 3.6-44.8）个月，而历史化疗组为 10.5（范围 3.0-16.5；p=0.047）个月。在接受 SIRT 作为一线治疗的患者中，中位 OS 为 18.7（范围 8.2-44.8）个月，明显长于化疗组（10.5 个月，p=0.017）。没有与治疗相关的死亡。毒性主要为 WHO 1-2 级，且为自限性。
SIRT 是治疗眼黑色素瘤肝转移的一种可行且安全的方法。
