Alix School of Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA.
Eye (Lond). 2021 Oct;35(10):2754-2762. doi: 10.1038/s41433-020-01295-y. Epub 2020 Nov 24.
BACKGROUND/OBJECTIVES: To report clinical outcomes of modified Collaborative Ocular Melanoma Study IRIS (COMS IRIS) plaques for treatment of iris, iridociliary, and ciliary body melanoma.
SUBJECTS/METHODS: Retrospective, single-centre cohort study of iris melanoma treated with COMS IRIS plaque radiotherapy from July 26, 2010 to October 15, 2018. Medical records were reviewed for demographics, tumour features, treatment parameters, and clinical outcomes.
There were 22 cases, diagnosed at mean age of 59 years (median 65, range 21-85 years) with female sex in 14 (64%). Presenting tumour features included Snellen visual acuity (VA) ≥ 20/40 in 18 (82%) cases, mean largest tumour basal diameter 4.7 mm (median 3.9, range 2.3-13.8 mm) and thickness 1.7 mm (median 1.6 mm, range 0.8-3.9 mm), iris stromal seeding in 3 (14%) cases, angle seeding in 16 (73%), and ciliary body involvement in 13 (59%). After mean follow-up of 51 months (median 44, range 4-113 months), Snellen VA was ≥20/40 in 14 (64%) cases, with local tumour recurrence in 2 (9%), and enucleation in 2 (9%). The 3-year Kaplan-Meier estimated risk of local tumour recurrence was 7%. The most common radiation side effects were cataract in 17 (77%) patients and dry eye in 5 (23%). Systemic metastasis occurred in no cases, and 1 (5%) non-melanoma-related death due to natural causes was observed at last follow-up.
COMS IRIS plaques are effective for treatment of iris, iridociliary, and ciliary body melanoma with modest VA outcomes and low frequency of local tumour recurrence, enucleation, radiation side effects, and systemic metastasis.
背景/目的：报告改良的协作性眼部黑色素瘤研究 IRIS（COMS IRIS）贴剂治疗虹膜、虹膜睫状体和睫状体黑色素瘤的临床结果。
受试者/方法：回顾性分析 2010 年 7 月 26 日至 2018 年 10 月 15 日期间，采用 COMS IRIS 贴剂放疗治疗虹膜黑色素瘤的单中心队列研究。对患者的人口统计学、肿瘤特征、治疗参数和临床结果进行了病历回顾。
共有 22 例患者，平均年龄 59 岁（中位数 65 岁，范围 21-85 岁），女性 14 例（64%）。初诊时的肿瘤特征包括 18 例（82%）视力≥20/40，最大肿瘤基底直径平均为 4.7mm（中位数 3.9mm，范围 2.3-13.8mm），厚度 1.7mm（中位数 1.6mm，范围 0.8-3.9mm），3 例（14%）虹膜基质播散，16 例（73%）房角播散，13 例（59%）睫状体受累。平均随访 51 个月（中位数 44 个月，范围 4-113 个月）后，14 例（64%）视力≥20/40，2 例（9%）局部肿瘤复发，2 例（9%）眼球摘除。3 年 Kaplan-Meier 估计局部肿瘤复发风险为 7%。最常见的放射性副作用是 17 例（77%）患者白内障和 5 例（23%）干眼症。无病例发生全身转移，末次随访时 1 例（5%）因自然原因发生非黑色素瘤相关死亡。
COMS IRIS 贴剂治疗虹膜、虹膜睫状体和睫状体黑色素瘤有效，视力结果尚可，局部肿瘤复发、眼球摘除、放射性副作用和全身转移的发生率较低。
