Rao Raksha, Honavar Santosh G, Lahane Sumeet, Mulay Kaustubh, Reddy Vijayanand Palkonda
Ocular Oncology Service, Centre for Sight, Hyderabad, Telangana, India.
Ocular Oncology Service, Centre for Sight, Hyderabad, Telangana, India
Br J Ophthalmol. 2023 May;107(5):621-626. doi: 10.1136/bjophthalmol-2021-319201. Epub 2021 Nov 29.
BACKGROUND/AIM: To evaluate the safety and efficacy of ruthenium-106 (Ru-106) plaque brachytherapy in managing invasive ocular surface squamous neoplasia (OSSN).
This is a retrospective, non-comparative, interventional case series of 42 eyes with OSSN with histopathologically-proven corneal stromal and/or scleral invasion that underwent Ru-106 plaque brachytherapy. Main outcome measures were tumour regression, eye salvage, final visual acuity, treatment complications and metastasis.
At presentation, the mean tumour basal diameter was 9.3 mm (range 5-26 mm) and thickness 3.1 mm (range 1.5-11 mm). Prior treatment included excision biopsy in two patients (5%), incision biopsy and topical interferon in one each (2%). Following excision with 4 mm clinically clear margins, corneal stromal and/or scleral invasion of OSSN was confirmed in all 42 cases, with the excised base showing invasive squamous cell carcinoma. A total dose of 5000 cGy over a mean duration of 19.7 hours (range 7-41 hours) was provided to an axial depth of 2 mm using Ru-106 surface plaque. Over a mean follow-up of 36.9 months (range 22.3-72 months), complete tumour regression was achieved in all eyes (100%). Two eyes (5%) showed conjunctival tumour growth remote from the site of prior treatment. Visual acuity was maintained at ≥20/200 in 35 eyes (83%), with a loss of >2 Snellen lines in 1 eye (2%). There was no evidence of regional lymph node or systemic metastasis.
Histopathology-guided use of Ru-106 surface plaque brachytherapy is a safe and an effective adjuvant therapy in the management of corneal stromal and/or scleral invasion of OSSN.
背景/目的：评估106钌（Ru-106）敷贴近距离放射治疗浸润性眼表鳞状上皮肿瘤（OSSN）的安全性和有效性。
这是一项回顾性、非对照、干预性病例系列研究，纳入42例经组织病理学证实有角膜基质和/或巩膜浸润的OSSN患者的42只眼，均接受了Ru-106敷贴近距离放射治疗。主要观察指标为肿瘤消退、眼球挽救、最终视力、治疗并发症和转移情况。
初诊时，肿瘤平均基底直径为9.3mm（范围5-26mm），厚度为3.1mm（范围1.5-11mm）。2例患者（5%）曾接受切除活检，1例（2%）曾接受切开活检，1例（2%）曾接受局部干扰素治疗。在临床切缘为4mm的情况下切除肿瘤后，42例均证实有OSSN的角膜基质和/或巩膜浸润，切除的基底显示为浸润性鳞状细胞癌。使用Ru-106表面敷贴，以2mm的轴向深度平均给予5000cGy的总剂量，平均持续时间为19.7小时（范围7-41小时）。平均随访36.9个月（范围22.3-72个月），所有患眼（100%）均实现肿瘤完全消退。2只眼（5%）在远离先前治疗部位的结膜出现肿瘤生长。35只眼（83%）的视力维持在≥20/200，1只眼（2%）视力下降超过2行Snellen视力表。没有区域淋巴结或全身转移的证据。
组织病理学引导下使用Ru-106表面敷贴近距离放射治疗是治疗OSSN角膜基质和/或巩膜浸润的一种安全有效的辅助治疗方法。
