Summanen P, Immonen I, Heikkonen J, Tommila P, Laatikainen L, Tarkkanen A
Department of Ophthalmology, Helsinki University Central Hospital, Finland.
Ophthalmic Surg. 1993 Feb;24(2):82-90.
A series of 100 consecutive patients treated by ruthenium plaque radiotherapy for uveal malignant melanoma from 1981 to 1991 was studied to evaluate local recurrences, metastases, and melanoma-specific mortality. Follow up ranged from 1.0 to 10.1 years (mean, 3.3; median, 3.0 years). Local relapse was observed in 19 patients from 0.1 to 2.7 years (median, 0.7 years) after therapy. Six of these eyes were enucleated. The 5-year probability of local tumor control was 59%. Seven patients with local relapse developed metastasis 0 to 4.3 years (median, 1.4 years) later. Altogether, 18 patients developed metastases 0.9 to 4.6 years (median, 2.0 years) after the irradiation, and 15 of them died of melanoma 5 days to 3.3 years (median, 0.5 years) after detection of metastases. The 5-year probability of metastasis not developing was 61%. The overall 5-year survival was 78%, excluding causes other than malignant melanoma. Large tumor size and anterior tumor location, with or without ciliary body involvement, predicted poor prognosis both in terms of local growth, metastases, and melanoma-specific mortality. Local recurrent tumor growth was associated with a significant increase in metastasis but a nonsignificant increase in melanoma-specific mortality.
对1981年至1991年间接受钌板放射治疗的100例连续性葡萄膜恶性黑色素瘤患者进行了研究，以评估局部复发、转移和黑色素瘤特异性死亡率。随访时间为1.0至10.1年（平均3.3年；中位数3.0年）。治疗后0.1至2.7年（中位数0.7年）有19例患者出现局部复发。其中6只眼被摘除。局部肿瘤控制的5年概率为59%。7例局部复发患者在0至4.3年（中位数1.4年）后发生转移。总共有18例患者在放疗后0.9至4.6年（中位数2.0年）发生转移，其中15例在检测到转移后5天至3.3年（中位数0.5年）死于黑色素瘤。未发生转移的5年概率为61%。排除恶性黑色素瘤以外的原因后，总体5年生存率为78%。肿瘤体积大及肿瘤位于前部，无论是否累及睫状体，在局部生长、转移和黑色素瘤特异性死亡率方面均预示预后不良。局部复发性肿瘤生长与转移的显著增加相关，但与黑色素瘤特异性死亡率的增加无显著相关性。
