Reichstein David A, Brock Anderson L
Tennessee Retina, Nashville, Tennessee, USA.
Curr Opin Ophthalmol. 2021 May 1;32(3):183-190. doi: 10.1097/ICU.0000000000000761.
Radiation therapy has become the standard of care for the treatment of uveal melanoma. We intend to outline the current radiation therapy methods that are employed to treat uveal melanoma. We will outline their relative benefits over one another. We will also provide some background about radiation therapy in general to accustom the ophthalmologists likely reading this review.
Four main options exist for radiation therapy of uveal melanoma. Because the eye is a small space, and because melanomas are relatively radioresistant, oncologists treating uveal melanoma must deliver highly focused doses in high amounts to a small space. Therapies incorporating external beams include proton beam therapy and stereotactic radiosurgery. Stereotactic radiosurgery comes in two forms, gamma knife therapy and cyberknife therapy. Radiation may also be placed directly on the eye surgically via plaque brachytherapy. All methods have been used effectively to treat uveal melanoma.
Each particular radiotherapy technique employed to treat uveal melanoma has its own set of benefits and drawbacks. The ocular oncologist can choose amongst these therapies based upon his or her clinical judgment of the relative risks and benefits. Availability of the therapy and cost to the patient remain significant factors in the ocular oncologist's choice.
放射治疗已成为葡萄膜黑色素瘤治疗的标准疗法。我们旨在概述目前用于治疗葡萄膜黑色素瘤的放射治疗方法。我们将阐述它们彼此之间的相对优势。我们还将提供一些关于放射治疗的总体背景知识，以使可能阅读本综述的眼科医生熟悉相关内容。
葡萄膜黑色素瘤的放射治疗有四种主要选择。由于眼睛是一个狭小空间，且黑色素瘤相对抗拒放疗，治疗葡萄膜黑色素瘤的肿瘤学家必须在小空间内给予高剂量的高度聚焦照射。采用外照射束的疗法包括质子束疗法和立体定向放射外科手术。立体定向放射外科手术有两种形式，即伽玛刀治疗和射波刀治疗。放射治疗也可通过敷贴近距离放射疗法经手术直接作用于眼部。所有这些方法都已有效地用于治疗葡萄膜黑色素瘤。
用于治疗葡萄膜黑色素瘤的每种特定放射治疗技术都有其自身的优缺点。眼科肿瘤学家可根据对相对风险和益处的临床判断在这些疗法中进行选择。治疗方法的可获得性以及患者的费用仍是眼科肿瘤学家决策时的重要因素。
