Gonsalves Carin F
Interventional Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania.
Semin Intervent Radiol. 2024 Mar 14;41(1):20-26. doi: 10.1055/s-0043-1777712. eCollection 2024 Feb.
Uveal melanoma is the most common primary intraocular tumor in adults. Approximately 50% of patients develop metastatic disease despite successful treatment of the primary eye tumor. The liver is the most common site of metastatic disease occurring in more than 90% of patients. Clinical prognosis is dependent on the ability to control the growth of liver tumors. Locoregional therapies play an important role in stabilizing liver metastases, prolonging survival for patients with metastatic uveal melanoma. As overall survival is prolonged, the development of extrahepatic disease becomes more common. Immunoembolization, a form of liver-directed therapy, not only focuses on treating hepatic metastases by stimulating the local immune system to suppress the growth of liver tumors, but it potentially generates a systemic immune response delaying the growth of extrahepatic metastases as well. The following article discusses immunoembolization for the treatment of metastatic uveal melanoma including the rationale, mechanism of action, indications, contraindications, outcomes, and associated toxicities.
葡萄膜黑色素瘤是成人最常见的原发性眼内肿瘤。尽管原发性眼肿瘤得到了成功治疗，但仍有大约50%的患者会发生转移性疾病。肝脏是转移性疾病最常见的部位，超过90%的患者会出现。临床预后取决于控制肝脏肿瘤生长的能力。局部区域治疗在稳定肝转移、延长转移性葡萄膜黑色素瘤患者的生存期方面发挥着重要作用。随着总体生存期的延长，肝外疾病的发生变得更加常见。免疫栓塞作为一种肝脏定向治疗形式，不仅专注于通过刺激局部免疫系统来抑制肝脏肿瘤生长从而治疗肝转移，而且它还可能产生全身免疫反应，延缓肝外转移的生长。以下文章讨论了免疫栓塞治疗转移性葡萄膜黑色素瘤，包括其基本原理、作用机制、适应症、禁忌症、疗效及相关毒性。
