Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, United States.
Department of Ophthalmology, Mayo Clinic, Rochester, MN, United States.
Asia Pac J Ophthalmol (Phila). 2019 Jan-Feb;8(1):30-35. doi: 10.22608/APO.2018257. Epub 2018 Oct 30.
To describe outcomes of 6 patients treated with plaque radiotherapy for medulloepithelioma.
Retrospective review.
Computerized medical records were reviewed for patients with cytopathologically confirmed medulloepithelioma and treated with plaque radiotherapy from January 1970 to December 2017. Clinical and radiotherapy parameters along with outcomes of tumor regression, globe salvage, and metastatic disease were recorded.
Of 6 patients with medulloepithelioma, plaque radiotherapy was primary (n = 5) or secondary (n = 1) treatment. The median patient age at diagnosis was 41 months (mean, 145; range, 10-624 months). Patient demographics included white race (n = 6) and female sex (n = 5). Patients presented with strabismus (n = 1), decreased vision (n = 1), ocular pain (n = 1), hyphema (n = 1), corectopia (n = 1), and visible iris lesion (n = 1). The mean tumor basal diameter was 11.2 mm (median, 10.0; range, 7.0-16.0 mm), and mean tumor thickness was 6.8 mm (median, 6.4; range, 3.1-11.0 mm). Related findings included cataract (n = 2), iris neovascularization (n = 5), secondary glaucoma (n = 2), and ectropion uveae (n = 2). The mean radiation dose to tumor apex was 44 Gy (median, 38; range, 35-70 Gy). At a mean follow-up of 59 months (range, 12-210 months), tumor control was achieved in 5 eyes (83%) with globe salvage in 4 eyes (67%). No patient had evidence of metastases or death at the last follow-up visit.
Plaque radiotherapy is a reasonable alternative treatment for localized, small- to medium-size medulloepithelioma. Tumors larger than 11.0 mm, with retrolental cyclitic membrane or extrascelral extension, might still require enucleation.
描述 6 例采用贴敷放疗治疗髓上皮瘤的患者的结果。
回顾性研究。
回顾 1970 年 1 月至 2017 年 12 月期间经细胞学证实为髓上皮瘤且接受贴敷放疗的患者的计算机病历。记录肿瘤消退、眼球保存和转移性疾病的临床和放射治疗参数及结果。
6 例髓上皮瘤患者中，5 例采用贴敷放疗作为初始治疗，1 例作为二线治疗。诊断时患者的中位年龄为 41 个月（平均 145 岁；范围 10-624 个月）。患者人口统计学特征包括白人（n=6）和女性（n=5）。患者表现为斜视（n=1）、视力下降（n=1）、眼部疼痛（n=1）、前房积血（n=1）、眼球偏位（n=1）和可见虹膜病变（n=1）。肿瘤基底直径的平均值为 11.2mm（中位数 10.0mm；范围 7.0-16.0mm），肿瘤厚度的平均值为 6.8mm（中位数 6.4mm；范围 3.1-11.0mm）。相关发现包括白内障（n=2）、虹膜新生血管形成（n=5）、继发性青光眼（n=2）和葡萄膜外翻（n=2）。肿瘤顶点的平均放射剂量为 44Gy（中位数 38Gy；范围 35-70Gy）。在平均 59 个月（范围 12-210 个月）的随访中，5 只眼（83%）的肿瘤得到控制并保存了眼球，4 只眼（67%）出现肿瘤局部控制和眼球保存。末次随访时，无患者出现转移或死亡。
对于局部小至中等大小的髓上皮瘤，贴敷放疗是一种合理的替代治疗方法。对于大于 11.0mm 的肿瘤，或存在视网膜后睫状膜或眼外延伸的肿瘤，可能仍需眼球摘除。
