Hager Annette, Meissner Friederike, Riechardt Aline-Isabel, Bonaventura Theresa, Löwen Julia, Heufelder Jens, Joussen Antonia M
Augenklinik, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
BerlinProtonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Graefes Arch Clin Exp Ophthalmol. 2019 Oct;257(10):2323-2328. doi: 10.1007/s00417-019-04413-z. Epub 2019 Jul 12.
Irradiation of choroidal melanoma is a safe and globe preserving procedure. Chronic inflammatory processes and ischemia are the main reasons for secondary enucleation in the long run. The aim of this study was to determine whether intraocular inflammation and especially inflammatory response after proton beam therapy (PBT) is related to primary tumor characteristics such as height, tumor volume, and initial flare values.
Twenty-six patients treated for uveal melanoma using PBT were included. All patients were examined for signs of inflammation using laser flare photometry (LFP). Each examination included assessment of the melanoma and fellow eye (which acted as the control) and imaging of the melanoma.
Significant differences of flare values between melanoma eyes and control group were found both at baseline (median 17.65 ph/ms (min 4, max 37.10), 7.45 ph/ms (min 0.80, max 16.40), respectively) and during follow-up (median 21.45 ph/ms (min 4.5, max 70.90); 6.05 ph/ms (min 2.40, max 16.40), respectively) (p < 0.001, Wilcoxon test). Flare values in melanoma eyes increased significantly after PBT (p = 0.005, Wilcoxon test) and after a follow-up of 94 days (median, 7-420 days). Flare values of the control group did not change (p = 0.946, Wilcoxon test). The increase of flare values correlated significantly with maximum tumor height and volume (Spearman-Rho 0.633, p = 0.001 and 0.519, p = 0.007, respectively).
LFP has proven to show significantly higher flare values in melanoma eyes as compared with the control group and provides data on the course of the inflammatory response after treatment. It may ease treatment planning both at baseline and during follow-up.
脉络膜黑色素瘤的放射治疗是一种安全且能保留眼球的治疗方法。从长期来看，慢性炎症过程和缺血是导致二次眼球摘除的主要原因。本研究的目的是确定眼内炎症，尤其是质子束治疗（PBT）后的炎症反应是否与肿瘤的原发特征有关，如高度、肿瘤体积和初始闪光值。
纳入26例接受PBT治疗的葡萄膜黑色素瘤患者。所有患者均使用激光闪光光度法（LFP）检查炎症体征。每次检查包括对黑色素瘤和对侧眼（作为对照）的评估以及黑色素瘤的成像。
在基线时（中位数分别为17.65 ph/ms（最小值4，最大值37.10）和7.45 ph/ms（最小值0.80，最大值16.40））以及随访期间（中位数分别为21.45 ph/ms（最小值4.5，最大值70.90）；6.05 ph/ms（最小值2.40，最大值16.40）），黑色素瘤眼和对照组之间的闪光值均存在显著差异（p < 0.001，Wilcoxon检验）。PBT后（p = 0.005，Wilcoxon检验）以及随访94天（中位数，7 - 420天）后，黑色素瘤眼的闪光值显著增加。对照组的闪光值没有变化（p = 0.946，Wilcoxon检验）。闪光值的增加与肿瘤最大高度和体积显著相关（Spearman-Rho分别为0.633，p = 0.001和0.519，p = 0.007）。
与对照组相比，LFP已被证明在黑色素瘤眼中显示出显著更高的闪光值，并提供了治疗后炎症反应过程的数据。它可能有助于在基线和随访期间的治疗规划。
