Kowal Joanna, Markiewicz Anna, Dębicka-Kumela Magdalena, Bogdali Anna, Romanowska-Dixon Boz Ena
Department of Ophthalmology and Ocular Oncology of University Hospital, Cracow.
Department of Ophthalmology and Ocular Oncology of the Jagiellonian University, Medical College, Cracow, Poland.
J Contemp Brachytherapy. 2018 Dec;10(6):532-541. doi: 10.5114/jcb.2018.79886. Epub 2018 Dec 28.
The aim of the study was an evaluation of I-125 brachytherapy patients with uveal melanoma with special consideration for the relationship of the treatment results and the irradiation dose applied to the tumor apex.
Medical records of 344 adults with uveal melanoma treated with I-125 brachytherapy in the Department of Ophthalmology and Ocular Oncology of the Jagiellonian University, Medical College in Cracow, Poland were retrospectively analyzed. The study was conducted between 2003 and 2012, and the study group was divided into two subgroups depending on the irradiation dose applied to the top of the tumor: 80 Gy to 100 Gy ( = 177) and 100 Gy to 120 Gy ( = 167).
It was found that the height of the tumor and the largest diameter of the tumor base decreased with every consecutive follow-up measurement and differed significantly in all comparisons ( < 0.0001). No significant correlation between frequency of complications was found between both study groups (χ = 0.27; = 0.6067). The correlation between survival and the irradiation dose as applied to the tumor top was statistically irrelevant (χ = 0.44; = 0.5084). A logistic regression model showed that patient survival depended on the largest diameter of the base and the height of tumor ( = 0.0216), and the risk of death was larger as these dimensions increased (IR, 1.17). An increase of the largest diameter of the base by 1 mm meant a 17% increase in chances of death. In 13.4% of cases, an enucleation was necessary.
The treatment of choroidal melanomas with I-125 iodine isotope brachytherapy is an efficient and recommended method of treatment and in many cases, an alternative to the enucleation of an eyeball.
本研究旨在评估接受碘-125近距离放射治疗的葡萄膜黑色素瘤患者，特别关注治疗结果与肿瘤顶端照射剂量之间的关系。
回顾性分析了波兰克拉科夫雅盖隆大学医学院眼科与眼肿瘤科344例接受碘-125近距离放射治疗的成年葡萄膜黑色素瘤患者的病历。研究于2003年至2012年进行，根据肿瘤顶端的照射剂量将研究组分为两个亚组：80 Gy至100 Gy（n = 177）和100 Gy至120 Gy（n = 167）。
发现肿瘤高度和肿瘤基底最大直径在每次连续随访测量时均减小，且在所有比较中差异均有统计学意义（P < 0.0001）。两个研究组之间并发症发生率无显著相关性（χ² = 0.27；P = 0.6067）。肿瘤顶端照射剂量与生存率之间的相关性无统计学意义（χ² = 0.44；P = 0.5084）。逻辑回归模型显示患者生存率取决于基底最大直径和肿瘤高度（P = 0.0216），且随着这些尺寸增加死亡风险更大（风险比，1.17）。基底最大直径增加1 mm意味着死亡几率增加17%。在13.4%的病例中，需要进行眼球摘除术。
用碘-125同位素近距离放射治疗脉络膜黑色素瘤是一种有效且推荐的治疗方法，在许多情况下可替代眼球摘除术。
