Liu Yating, Rokohl Alexander C, Guo Yongwei, Yao Ke, Fan Wanlin, Heindl Ludwig M
Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Center for Integrated Oncology (CIO), Aachen-Bonn-Cologne-Duesseldorf, Cologne, Germany.
Adv Ophthalmol Pract Res. 2024 Apr 13;4(3):112-119. doi: 10.1016/j.aopr.2024.03.005. eCollection 2024 Aug-Sep.
Intraocular malignant tumors represent a severe disease that threatens vision as well as life. To better extend the life of the patient, preserve visual function, and maintain ocular aesthetics, selecting the appropriate timing and methods of treatment becomes crucial.
With the continuous advancement of medical technology, the techniques and methods for treating intraocular malignant tumors are constantly evolving. While surgery was once considered the optimal method to prolong patient survival and prevent local recurrence, the discovery and application of various treatments such as radiotherapy, laser therapy, chemotherapy, cryotherapy, and monoclonal antibodies have led to a greater diversity of treatment options. This diversity offers more possibilities to develop personalized treatment plans, and thereby maximize patient benefit. This article reviews the various treatment methods for intraocular malignant tumors, including indications for treatment, outcomes, and potential complications.
Differentiating small intraocular malignant tumors from pigmented lesions is challenging, and ongoing monitoring with regular follow-up is required. Small to medium-sized tumors can be treated with radiotherapy combined with transpupillary thermotherapy. Depending on the tumor's distance from the optic disc, surgery with partial resection may be considered for distant tumors, while proximal tumors may require complete enucleation. Systemic chemotherapy has been widely applied to patients with retinal tumors, lymphomas, and intraocular metastatic cancers, but has limited efficacy in patients with choroidal melanoma. Antagonists of Vascular Endothelial Growth Factor (Anti-VEGF) drugs can improve patient vision and quality of life, while the efficacy of immunotherapy and molecular targeted therapy is still under research.
眼内恶性肿瘤是一种严重疾病,会威胁视力和生命。为了更好地延长患者生命、保留视觉功能并维持眼部美观,选择合适的治疗时机和方法至关重要。
随着医学技术的不断进步,眼内恶性肿瘤的治疗技术和方法也在不断发展。虽然手术曾被认为是延长患者生存期和预防局部复发的最佳方法,但放疗、激光治疗、化疗、冷冻疗法和单克隆抗体等各种治疗方法的发现和应用,使治疗选择更加多样化。这种多样性为制定个性化治疗方案提供了更多可能性,从而使患者受益最大化。本文综述了眼内恶性肿瘤的各种治疗方法,包括治疗适应证、治疗效果和潜在并发症。
鉴别小的眼内恶性肿瘤与色素沉着病变具有挑战性,需要定期随访进行持续监测。中小肿瘤可采用放疗联合经瞳孔温热疗法治疗。根据肿瘤与视盘的距离,对于距离较远的肿瘤可考虑行部分切除手术,而距离较近的肿瘤可能需要行眼球摘除术。全身化疗已广泛应用于视网膜肿瘤、淋巴瘤和眼内转移性癌患者,但对脉络膜黑色素瘤患者疗效有限。血管内皮生长因子拮抗剂(抗VEGF)药物可改善患者视力和生活质量,而免疫疗法和分子靶向疗法的疗效仍在研究中。