Department of Ophthalmology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Department of Ophthalmology, Erasmus University Medical Centre, Rotterdam, the Netherlands.
Radiother Oncol. 2021 Apr;157:219-224. doi: 10.1016/j.radonc.2021.01.030. Epub 2021 Feb 4.
To compare the adverse side effects of fractionated stereotactic photon beam radiotherapy (fSRT) with proton beam radiotherapy (PBR) in patients with uveal melanoma (UM).
A retrospective study investigating 306 UM patients treated with fSRT (N=153) by the Rotterdam Ocular Melanoma Study group (ROMS), The Netherlands, between 1999-2014 or with PBR (N=153) at the Royal Liverpool University Hospital and the Clatterbridge Cancer Centre, Bebington, United Kingdom, between 1993-2014. The tumours treated with fSRT were matched with tumours treated with PBR based on sex, left or right eye, TNM classification, posterior margin ≤ or > 3mm of the fovea and of the optic disc.
The five-year actuarial rates of tumour recurrence were 4.5% for fSRT and 6.1% for PBR. For fSRT and PBR, the five-year actuarial rates of maculopathy were 14.9% and 12.4%, and for vitreous haemorrhage were 29.4% and 4.7%, respectively. Only vitreous haemorrhage (HR: 0.19, 95% CI: 0.07-0.56) was more common after fSRT compared to PBR. Overall, larger tumours were risk factors for maculopathy and secondary enucleation.
Both treatments have excellent local tumour control. In matched groups, vitreous haemorrhage was the only adverse side effect showing a significant difference between groups.
比较分割立体定向光子束放射治疗（fSRT）与质子束放射治疗（PBR）在葡萄膜黑色素瘤（UM）患者中的不良反应。
一项回顾性研究，调查了 1999-2014 年间荷兰鹿特丹眼部黑色素瘤研究组（ROMS）采用 fSRT 治疗的 306 例 UM 患者（n=153），或 1993-2014 年间英国皇家利物浦大学医院和贝宾顿克拉特桥癌症中心采用 PBR 治疗的 153 例 UM 患者。根据性别、左眼或右眼、TNM 分类、后缘距黄斑和视盘≤或>3mm，将 fSRT 治疗的肿瘤与 PBR 治疗的肿瘤进行匹配。
fSRT 和 PBR 的五年肿瘤复发累积发生率分别为 4.5%和 6.1%。fSRT 和 PBR 的五年黄斑病变累积发生率分别为 14.9%和 12.4%，玻璃体出血发生率分别为 29.4%和 4.7%。与 PBR 相比，fSRT 后仅玻璃体出血更常见（HR：0.19，95%CI：0.07-0.56）。总体而言，较大的肿瘤是黄斑病变和二次眼球摘除的危险因素。
两种治疗方法均具有良好的局部肿瘤控制效果。在匹配组中，玻璃体出血是两组之间唯一具有显著差异的不良反应。
