Gillam Matthew, Fenech Glenn Ace, Chadwick Oliver, Nairn Jonathan, Chadha Vikas, Connolly Julie, Cram Oliver, Kincaid Wilma, Cauchi Paul
Department of Ophthalmology, Chelsea and Westminster Hospitals NHS Foundation Trust, London, UK.
Tennent Institute of Ophthalmology, NHS Greater Glasgow and Clyde, Glasgow, UK.
Ocul Oncol Pathol. 2023 Dec;9(5-6):130-137. doi: 10.1159/000533308. Epub 2023 Aug 2.
Proton beam therapy (PBT) is an effective treatment option for uveal melanomas. Following treatment, it may take many months for the tumour to respond and it may initially enlarge. We reviewed our PBT patients to determine when they showed a radiological response to treatment.
Patients undergoing PBT for ciliary body or choroidal melanomas between 2008 and 2018 were included. Data were collected on patient demographics, treatments before and after PBT and survival. All ultrasound investigations prior and since PBT were reviewed and tumour volume calculated using a validated formula for a half-ellipsoid shape.
193 patients were analysed, 169 with choroidal and 24 with ciliary body melanomas. 31.6% patients had other treatment prior to PBT. At a mean of 8 months post-PBT, 64.7% of patients had a reduced tumour volume with 20.2% having larger tumours. At a mean of 15 months post-treatment, these figures were 67.8% and 10.3%. 18.1% of patients had an enucleation during the study period. The earliest responses were seen at 2 months, the latest at 32 months post-treatment. 5-year melanoma-specific survival was 82.3%.
In our study, by 6 months post-PBT, a majority of patients show a reduction in tumour volume. Of those that do not, many respond in the next 6 months and a response may be seen up to 32 months after treatment. Patients may need to be monitored for up to 32 months to see a final response to PBT treatment.
质子束疗法（PBT）是葡萄膜黑色素瘤的一种有效治疗选择。治疗后，肿瘤可能需要数月时间才会出现反应，并且最初可能会增大。我们对接受PBT治疗的患者进行了回顾，以确定他们何时出现治疗的放射学反应。
纳入2008年至2018年间接受PBT治疗睫状体或脉络膜黑色素瘤的患者。收集了患者人口统计学、PBT前后的治疗情况以及生存数据。回顾了PBT之前及之后的所有超声检查，并使用经过验证的半椭球体形状公式计算肿瘤体积。
分析了193例患者，其中169例为脉络膜黑色素瘤，24例为睫状体黑色素瘤。31.6%的患者在PBT之前接受过其他治疗。PBT后平均8个月时，64.7%的患者肿瘤体积减小，20.2%的患者肿瘤增大。治疗后平均15个月时，这些数字分别为67.8%和10.3%。在研究期间，18.1%的患者进行了眼球摘除术。最早的反应出现在治疗后2个月，最晚出现在32个月。5年黑色素瘤特异性生存率为82.3%。
在我们的研究中，PBT后6个月时，大多数患者的肿瘤体积减小。未减小的患者中，许多人在接下来的6个月内出现反应，治疗后32个月内都可能出现反应。可能需要对患者进行长达32个月的监测，以观察对PBT治疗的最终反应。
