Finger Paul T
The New York Eye Cancer Center, New York, NY, USA.
J Vitreoretin Dis. 2024 Feb 18;8(2):210-214. doi: 10.1177/24741264241227684. eCollection 2024 Mar-Apr.
To describe the first use of high-dose-rate yttrium-90 disc brachytherapy for choroidal melanoma. A 72-year-old patient had a cT1-category choroidal melanoma characterized by the presence of orange pigment, increasing subretinal fluid (SRF), and enlarging tumor thickness. It was treated with single-session, light-guided, light-defined yttrium-90-disc brachytherapy. A specialized handheld applicator provided with 4 encircling lights was used to guide plaque placement and localize treatment. Unlike low-dose-rate plaques, high-dose-rate yttrium-90 required only 3 minutes 39 seconds. In this case, treatment did not require episcleral sutures, muscle relocation, outpatient dwell time, or a second surgery. High-dose-rate treatment improved radiation safety by eliminating perioperative exposure to health care personnel, the community, and the family. At the 13-month follow-up, the SRF and tumor thickness were diminished. There was no secondary cataract, radiation retinopathy, maculopathy, or optic neuropathy, and the visual acuity was 20/20. Yttrium-90 brachytherapy allowed for single-surgery, minimally invasive, outpatient irradiation of a choroidal melanoma.
描述高剂量率钇-90盘状近距离放射治疗脉络膜黑色素瘤的首次应用。一名72岁患者患有cT1级脉络膜黑色素瘤，其特征为存在橙色色素、视网膜下液（SRF）增加和肿瘤厚度增大。该患者接受了单疗程、光导、光定位钇-90盘状近距离放射治疗。使用配备4个环绕灯的专用手持敷贴器来引导斑块放置并确定治疗位置。与低剂量率斑块不同，高剂量率钇-90仅需3分39秒。在此病例中，治疗无需巩膜外缝合、肌肉移位、门诊停留时间或二次手术。高剂量率治疗通过消除围手术期对医护人员、社区和家庭的辐射暴露，提高了放射安全性。在13个月的随访中，SRF和肿瘤厚度减小。未出现继发性白内障、放射性视网膜病变、黄斑病变或视神经病变，视力为20/20。钇-90近距离放射治疗实现了脉络膜黑色素瘤的单手术、微创、门诊照射。
