Missotten L, Dirven W, Van der Schueren A, Leys A, De Meester G, Van Limbergen E
Department of Ophthalmology, University Hospital, Leuven, Belgium.
Graefes Arch Clin Exp Ophthalmol. 1998 Mar;236(3):164-73. doi: 10.1007/s004170050059.
We review the results of treatment of small to medium-sized choroidal malignant melanomas after high-dose-rate brachytherapy with a strontium-90 applicator.
The applicator is positioned against the sclera using an afterloading technique. Brachytherapy is completed in a single session lasting 2-4 h with the patient under local anaesthesia. From September 1983 until March 1995, 46 eyes were treated in this way. Most tumours were 7-11 mm in diameter (range from 4.5-15 mm) with a mean height of approximately 3 mm (range from 1.5-7 mm). Follow-up ranged from 6 months to 12 years (mean 49 months).
Thirty of the 46 eyes had at the final evaluation a nonevolutive scar (20 of these after a single application, the others with some additional treatment). In 13 eyes the tumours were in involution but their complete destruction was not yet certain, and 3 eyes were enucleated for local recurrence. Three patients developed systemic metastases. No radiogenic complications were noticed.
Strontium-90 brachytherapy is a valuable and safe treatment technique for small to medium-sized choroidal malignant melanomas. In addition the use of a strontium-90 applicator is inexpensive thanks to this element's long half-life and the short application time.
我们回顾了使用锶 - 90敷贴器进行高剂量率近距离放射治疗后中小型脉络膜恶性黑色素瘤的治疗结果。
采用后装技术将敷贴器贴靠巩膜放置。在局部麻醉下，患者接受单次持续2 - 4小时的近距离放射治疗。从1983年9月至1995年3月，共对46只眼采用此方法进行治疗。大多数肿瘤直径为7 - 11毫米（范围4.5 - 15毫米），平均高度约为3毫米（范围1.5 - 7毫米）。随访时间为6个月至12年（平均49个月）。
46只眼中有30只在最终评估时形成了无进展的瘢痕（其中20只单次治疗后形成，其他经过一些额外治疗）。13只眼中肿瘤在消退，但尚未确定完全破坏，3只眼因局部复发而被摘除眼球。3例患者发生全身转移。未发现放射性并发症。
锶 - 90近距离放射治疗是中小型脉络膜恶性黑色素瘤一种有价值且安全的治疗技术。此外，由于锶 - 90元素半衰期长且应用时间短，使用锶 - 90敷贴器成本低廉。
