Paryani S B, Scott W P, Wells J W, Johnson D W, Chobe R J, Kuruvilla A, Schoeppel S, Deshmukh A
Williams Cancer Center, Baptist Medical Center, Jacksonville, FL 32207.
Int J Radiat Oncol Biol Phys. 1994 Jan 1;28(1):101-3. doi: 10.1016/0360-3016(94)90146-5.
To compare our results in the management of pterygium using a higher total dose with other reported results.
Between 1971 and 1991, 690 patients were treated with complete surgical excision followed by beta irradiation for primary or recurrent pterygium. Of these patients, 129 had two or more areas involving both eyes for a total of 825 lesions treated. Only 17 patients (2%) had temporal lesions with the rest of the patients having nasal pterygia. All patients underwent complete surgical resection of the pterygium before undergoing radiation therapy. One hundred forty-nine patients had undergone previous surgical resection alone but developed recurrence. After surgical excision, all patients were treated with Strontium-90 applicators starting immediately within 24 hr of surgery. Our standard policy was six weekly applications, each delivering a surface dose of 1000 cGy. The total dose delivered was 6000 cGy. Minimum follow-up was 1 year with a median of greater than 8 years.
There were only fourteen recurrences (1.7%) out of a total of 825 lesions treated. Nine of the fourteen patients received suboptimal therapy undergoing less than five applications of Strontium-90. There were no major complications.
The combination of surgical excision followed by adequate Strontium-90 applications is highly effective in the management of pterygium. The optimal total dose appears to be in the range of 2000 cGy to 6000 cGy.
将我们使用更高总剂量治疗翼状胬肉的结果与其他报告的结果进行比较。
1971年至1991年间，690例原发性或复发性翼状胬肉患者接受了完整手术切除，随后进行β射线照射。在这些患者中，129例双眼有两个或更多受累区域，共治疗825处病变。仅17例患者（2%）有颞侧病变，其余患者为鼻侧翼状胬肉。所有患者在接受放射治疗前均接受了翼状胬肉的完整手术切除。149例患者此前仅接受过手术切除，但出现了复发。手术切除后，所有患者在术后24小时内立即开始使用锶-90敷贴器治疗。我们的标准方案是每周敷贴6次，每次表面剂量为1000 cGy。总剂量为6000 cGy。最短随访时间为1年，中位随访时间超过8年。
在总共治疗的825处病变中，仅14处复发（1.7%）。14例复发患者中有9例接受的治疗不充分，锶-90敷贴次数少于5次。无严重并发症。
手术切除联合适当的锶-90敷贴治疗翼状胬肉非常有效。最佳总剂量似乎在2000 cGy至6000 cGy范围内。
