Plaque radiotherapy for juxtapapillary choroidal melanoma: treatment complications and visual outcomes in 650 consecutive cases.
Plaque radiotherapy for juxtapapillary choroidal melanoma: treatment complications and visual outcomes in 650 consecutive cases.
复制标题
斑块放射治疗近乳头脉络膜黑色素瘤：650 例连续病例的治疗并发症和视力结果。
作者：
M. Sagoo;C. Shields;J. Emrich;A. Mashayekhi;L. Komarnicky;J. Shields
重要性
乳头旁脉络膜黑色素瘤的治疗具有挑战性，因为肿瘤靠近视觉上重要的结构。
客观化
目的探讨斑块放射治疗乳头旁脉络膜黑色素瘤的并发症。
设计、设置和参与者
在这组来自Wills眼科医院眼科肿瘤科的病例中，我们研究了1974年10月1日至2005年11月30日期间连续接受斑块放射治疗的视盘旁脉络膜黑色素瘤(≤1 mm)患者。
主要成果和措施
对放射并发症、二次眼球摘除和视力结果进行Kaplan-Meier分析。
结果
5年(10年)非增殖性视网膜病变的发生率为66%(75%)；增殖性视网膜病变为24%(32%)；黄斑病变为56%(65%)；乳头病变为61%(77%)；白内障为66%(80%)；新生血管性青光眼为15%(22%)；玻璃体出血为35%(42%)；继发性眼球摘除为16%(26%)。视力在20/200或以上者占54%(87%)，Snellen视力下降5行以上者占45%(78%)。
结论和相关性
在这一系列病例中，斑块放射治疗乳头旁脉络膜黑色素瘤通常导致视网膜病变和乳头状病变，但5年后眼球滞留率为84%。视力损失应在5年内达到45%。斑块放疗仍然是治疗球保留率高的乳头旁黑色素瘤的合适选择。
IMPORTANCE
The treatment of juxtapapillary choroidal melanoma is challenging because of the proximity of the tumor to visually important structures.
OBJECTIVE
To report the complications of treatment of juxtapapillary choroidal melanoma with plaque radiotherapy.
DESIGN, SETTING, AND PARTICIPANTS
In this retrospective case series of patients from the Ocular Oncology Service, Wills Eye Hospital, 650 consecutive eyes with juxtapapillary choroidal melanoma (≤1 mm to optic disc) treated with plaque radiotherapy from October 1, 1974, through November 30, 2005, were studied.
MAIN OUTCOMES AND MEASURES
Kaplan-Meier analysis of rates of radiation complications, secondary enucleation, and visual acuity outcomes.
RESULTS
The 5-year (10-year) rate of nonproliferative retinopathy was 66% (75%); proliferative retinopathy, 24% (32%); maculopathy, 56% (65%); papillopathy, 61% (77%); cataract, 66% (80%); neovascular glaucoma, 15% (22%); vitreous hemorrhage, 35% (42%); and secondary enucleation, 16% (26%). Visual acuity of 20/200 or worse occurred in 54% (87%), and loss of more than 5 lines of Snellen visual acuity was found in 45% (78%).
CONCLUSIONS AND RELEVANCE
Among this case series, plaque radiotherapy for juxtapapillary choroidal melanoma commonly led to retinopathy and papillopathy, but globe retention was 84% at 5 years. Vision loss should be anticipated in 45% by 5 years. Plaque radiotherapy remains a suitable choice for the treatment of juxtapapillary melanoma with a high globe retention rate.
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DOI：
10.1001/archopht.1985.01050110067027
发表时间：
1985
期刊：
Archives of ophthalmology (Chicago, Ill. : 1960)
影响因子：
--
作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
Boldt HC;Melia BM;Liu JC;Reynolds SM;Collaborative Ocular Melanoma Study Group
通讯作者：
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影响因子：
13.7
作者：
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通讯作者：
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DOI：
10.1001/archopht.119.7.951
发表时间：
2001
期刊：
Archives of ophthalmology (Chicago, Ill. : 1960)
影响因子：
--
作者：
Diener-West,M;Earle,JD;Fine,SL;Hawkins,BS;Moy,CS;Reynolds,SM;Schachat,AP;Straatsma,BR;CollaborativeOcularMelanomaStudyGroup
通讯作者：
CollaborativeOcularMelanomaStudyGroup