Stannard C, Sealy R, Shackleton D, Hill J, Korrubel J
Department of Radiotherapy, Groote Schuur Hospital, Republic of South Africa.
Ophthalmic Paediatr Genet. 1987 Jun;8(2):89-93. doi: 10.3109/13816818709028523.
125I has an energy of 27-35 keV which permits highly effective screening and makes it eminently suitable for treating ophthalmic tumours. It was first used for this in 1974 (Sealy et al., 1976), and since then a flexible system has been developed to treat a variety of such tumours including localized retinoblastoma. A gold foil backed plaque is custom built to cover the tumour(s). The turned edges reduce the dose and thus protect vital adjacent structures such as the optic nerve and lens. The iodine seeds are sealed in the plaque in a predetermined position to give the required dose. A range of doses and times have been used but the authors now aim to give a TDF of 100 to the apex of the tumour in two to three days. Ten tumours in the remaining eye of seven patients with bilateral retinoblastoma were treated. The size ranged from 3 X 3 X 2 to 10 X 10 X 6 mm. There were nine complete responses from 17-90 months and a partial response in one patient who died of metastases at ten months. Vision was maintained in all. Eight recurrent tumours in seven patients were also treated together with a subsequent new tumour in one of the patients. There were three complete responses at 28-39 months and six tumours persisted. Vision was maintained in three of seven patients. The only complication was a vitreous haemorrhage which was mild in two patients, moderate in one patient and severe in three previously treated patients. These latter three patients subsequently had the eye enucleated and were found to have recurrent tumour.
125I的能量为27 - 35千电子伏特，这使得它能够进行高效筛查，非常适合治疗眼部肿瘤。1974年它首次被用于此（西利等人，1976年），从那时起，已经开发出一种灵活的系统来治疗包括局限性视网膜母细胞瘤在内的各种此类肿瘤。定制一个带有金箔背衬的斑块来覆盖肿瘤。翻边可减少剂量，从而保护重要的相邻结构，如视神经和晶状体。碘籽源被密封在斑块中的预定位置，以提供所需剂量。已经使用了一系列的剂量和时间，但作者现在的目标是在两到三天内给肿瘤顶点给予100的肿瘤致死剂量（TDF）。对7例双侧视网膜母细胞瘤患者的患侧眼的10个肿瘤进行了治疗。肿瘤大小范围为3×3×2至10×10×6毫米。17至90个月内有9例完全缓解，1例患者在10个月时死于转移，为部分缓解。所有患者视力均得以维持。还对7例患者的8个复发性肿瘤以及其中1例患者随后出现的新肿瘤进行了治疗。28至39个月时有3例完全缓解，6个肿瘤持续存在。7例患者中有3例视力得以维持。唯一的并发症是玻璃体出血，2例患者为轻度，1例患者为中度，3例先前接受过治疗的患者为重度。后3例患者随后接受了眼球摘除术，发现患有复发性肿瘤。
