Lederman M, Wybar K, Busby E
Br J Ophthalmol. 1984 Sep;68(9):605-17. doi: 10.1136/bjo.68.9.605.
One hundred and eighty-four cases of malignant melanoma of the lids and epibulbar region were seen in the Radiotherapy Department of the Royal Marsden Hospital during the period 1943-74. Some of these tumours were radiosensitive and could thus be treated by radiotherapy without loss of the affected eye. Their clinical and histological features are described. The treatment policy adopted was based on radiotherapy first, and surgery reserved for the failures. A policy of observation is advised for precancerous melanosis, and active treatment should be undertaken only if malignancy supervenes. The contraindications for radiotherapy, the factors governing radiosensitivity, and the incidence and site of metastases are reported, and the possible effect on the metastatic and survival rates of leaving the eye are discussed. Active treatment of the node-free neck is not advised. Results are given according to site, histology, and treatment method, and the frequency with which the eye was lost is shown, since the sole advantage of radiotherapy over surgery is the possibility of saving the eye without worsening the prognosis for survival.
1943年至1974年期间，皇家马斯登医院放疗科共收治了184例眼睑及眼球表面恶性黑色素瘤患者。其中一些肿瘤对放疗敏感，因此可通过放疗进行治疗而无需摘除患眼。本文描述了这些肿瘤的临床和组织学特征。所采用的治疗策略是以放疗为先，手术则留待放疗失败时使用。对于癌前黑素沉着症，建议采取观察策略，仅在发生恶变时才进行积极治疗。报告了放疗的禁忌症、影响放射敏感性的因素以及转移的发生率和部位，并讨论了保留眼球对转移率和生存率可能产生的影响。不建议对无淋巴结转移的颈部进行积极治疗。根据肿瘤部位、组织学类型和治疗方法给出了结果，并显示了眼球摘除的频率，因为放疗相对于手术的唯一优势在于有可能在不恶化生存预后的情况下保住眼球。
