The New York Eye Cancer Center, New York, NY, USA.
Eur J Ophthalmol. 2021 May;31(3):1375-1383. doi: 10.1177/1120672120914235. Epub 2020 Apr 20.
To investigate the safety and tolerability of total anterior segment palladium-103 (Pd) eye plaque brachytherapy for multifocal iris melanoma.
Interventional case series of 11 patients with multifocal iris melanomas. Anterior segment ultrasound revealed tumor size, location, and intraocular margins. Epicorneal amniotic membrane grafts protected the cornea and decreased pain during total anterior segment 103-Pd ophthalmic plaque brachytherapy.
Eleven diffuse iris melanomas were American Joint Committee on Cancer 8th edition-classified as T1 (n = 5, 45.5%) and T2 (n = 6, 54.5%). Plaque radiation was completed to a minimum mean tumor dose of 85 Gy (mean dose rate, 58.1 cGy/h). Ultrasonographic tumor thickness regression was 41% (follow up mean 58.7, median 50, range: 8-139 months). Despite 100% local control and 100% eye retention, one patient (9.1%) developed metastatic disease. Four eyes required cataract surgery. There was no corneal stem-cell deficiency, corneal opacity, radiation maculopathy, or optic neuropathy. While visual acuity prior to treatment was 20/40 or better in 10 (91%), 9 were 20/40 or better (81.9%) at last follow-up. Four (36%) had glaucoma prior to treatment and three eyes developed glaucoma after treatment for a total of 63%.
Total anterior segment (Pd) plaque brachytherapy resulted in local control, good visual acuity, eye and life preservation in the treatment of multifocal iris melanoma.
研究全前节钯-103（Pd）眼贴敷近距离放疗治疗多灶性虹膜黑色素瘤的安全性和耐受性。
对 11 例多灶性虹膜黑色素瘤患者进行介入性病例系列研究。眼前段超声检查显示肿瘤大小、位置和眼内边界。角膜缘上皮羊膜移植保护角膜，减少全前节 103-Pd 眼科贴敷近距离放疗期间的疼痛。
11 例弥漫性虹膜黑色素瘤根据美国癌症联合委员会第 8 版分类为 T1（n=5，45.5%）和 T2（n=6，54.5%）。对肿瘤进行贴敷放疗，使最小平均肿瘤剂量达到 85Gy（平均剂量率为 58.1cGy/h）。超声检查肿瘤厚度消退率为 41%（随访平均 58.7 个月，中位数 50 个月，范围：8-139 个月）。尽管 100%的局部控制率和 100%的保眼率，但仍有 1 例（9.1%）患者发生远处转移。4 只眼需要白内障手术。无角膜干细胞缺乏、角膜混浊、放射性黄斑病变或视神经病变。治疗前视力为 20/40 或更好的有 10 例（91%），治疗后 9 例（81.9%）为 20/40 或更好。治疗前有 4 例（36%）患有青光眼，治疗后 3 只眼发生青光眼，总发生率为 63%。
全前节（Pd）贴敷近距离放疗治疗多灶性虹膜黑色素瘤可获得局部控制、良好的视力、保眼和保存生命。
