Gragoudas E S, Goitein M, Koehler A M, Verhey L, Tepper J, Suit H D, Brockhurst R, Constable I J
Am J Ophthalmol. 1977 May;83(5):665-73. doi: 10.1016/0002-9394(77)90133-7.
Five patients with choroidal malignant melanomas were treated with proton irradiation with a cyclotron. We developed an accurate method of aiming the proton beam within the eye. Four to five tantalum rings, 2 mm in diameter, were sutured to the sclera at the edges of the tumor, which is localized by indirect ophthalmoscopy and transillumination. The rings were used as markers for stereotactic radiography to align precisely the tumors with the proton beam. The patients were given a total tumor dose of 4,730 to 6,670 rads, delivered in five equal fractions, over a period of eight to nine days. All patients tolerated the treatments well without any adverse effects. The tumor response to therapy could not be evaluated at the completion of treatment since there was no immediate observable reaction of the tumor or of the surrounding retina. Although there has been no definite regression in any patient, we observed a change in the "color" of the tumor in the first two patients and resolution of two serous retinal detachments.
5例脉络膜恶性黑色素瘤患者接受了回旋加速器质子照射治疗。我们开发了一种在眼内精确瞄准质子束的方法。通过间接检眼镜和透照法确定肿瘤位置后，将4至5个直径2毫米的钽环缝合到肿瘤边缘的巩膜上。这些环用作立体定向放射摄影的标记物，以便将肿瘤与质子束精确对准。患者接受的肿瘤总剂量为4730至6670拉德，分5等份，在8至9天内给予。所有患者对治疗耐受性良好，无任何不良反应。治疗结束时无法评估肿瘤对治疗的反应，因为肿瘤或周围视网膜没有立即出现可观察到的反应。虽然没有任何患者出现明确的肿瘤消退，但我们观察到前两名患者的肿瘤“颜色”发生了变化，并且有2例浆液性视网膜脱离得到了缓解。
