Miao Yuxin, Zheng Tingwei, Zhang Qiuning, Li Meixuan, Lei Qihang, Liu Qin, Luo Hongtao, Bai Huiling
The First School of Clinical Medical, Gansu University of Chinese Medicine, Lanzhou, 730000, China.
Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China.
Radiat Oncol. 2025 Jan 11;20(1):7. doi: 10.1186/s13014-024-02580-w.
Proton beam therapy (PBT) has been gradually introduced for treating choroidal melanoma. This study systematically reviewed clinical reports to evaluate the efficacy and safety of PBT in choroidal melanoma patients.
This systematic review included all the primary studies involving PBT for choroidal melanoma patients through April 2024. Four publicly accessible databases were searched, and the statistical data were analyzed using STATA 15.0. The outcomes of interest included overall survival (OS), metastasis-free survival, local control rate, and adverse reactions.
A total of six case series involving 1059 patients with choroidal melanoma were included. The random effect model meta-analysis showed that the 2-, 3-, 5-, and 10-year OS rates of patients with choroidal melanoma treated with PBT were 97%, 92%, 73%, and 39%, respectively. The metastasis-free survival rates at 2, 3, and 5 years were 92%, 89%, and 76%, respectively, and the local control rates at 1, 3, 5, and 10 years were 98%, 92%, 94%, and 88%, respectively. Four studies reported adverse reactions. The most common adverse reactions after PBT were glaucoma, optic neuropathy, and cataracts, with incidence rates ranging from 17.9 to 27%, 12.8-64%, and 29.6-39.8%, respectively.
This meta-analysis identified PBT as a vital local treatment strategy against choroidal melanoma. Both OS and local control rates showed excellent results. However, more prospective trials can help compare the efficacy of PBT with typical therapy.
质子束治疗（PBT）已逐渐被引入用于治疗脉络膜黑色素瘤。本研究系统回顾了临床报告，以评估PBT在脉络膜黑色素瘤患者中的疗效和安全性。
本系统评价纳入了截至2024年4月所有涉及PBT治疗脉络膜黑色素瘤患者的原始研究。检索了四个可公开访问的数据库，并使用STATA 15.0分析统计数据。感兴趣的结局包括总生存期（OS）、无转移生存期、局部控制率和不良反应。
共纳入6个病例系列，涉及1059例脉络膜黑色素瘤患者。随机效应模型荟萃分析显示，接受PBT治疗的脉络膜黑色素瘤患者的2年、3年、5年和10年总生存率分别为97%、92%、73%和39%。2年、3年和5年的无转移生存率分别为92%、89%和76%，1年、3年、5年和10年的局部控制率分别为98%、92%、94%和88%。四项研究报告了不良反应。PBT后最常见的不良反应是青光眼、视神经病变和白内障，发生率分别为17.9%至27%、12.8%至64%和29.6%至39.8%。
这项荟萃分析确定PBT是治疗脉络膜黑色素瘤的重要局部治疗策略。总生存期和局部控制率均显示出优异的结果。然而，更多的前瞻性试验有助于比较PBT与传统疗法的疗效。
