Eye retention after proton beam radiotherapy for uveal melanoma
Eye retention after proton beam radiotherapy for uveal melanoma
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DOI：
10.1016/s0360-3016(02)04200-1
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发表时间：
2003-03-15
影响因子：
7
通讯作者：
Goitein, G
中科院分区：
文献类型：
--
作者：
Egger, E;Zografos, L;Goitein, G
目的：分析质子束放射治疗葡萄膜黑色素瘤保守治疗后眼球保留的长期结果，并分析保守治疗后导致眼球摘除的原因。方法和材料：这是一项前瞻性、非比较性、介入性、连续病例系列。 1984 年至 1999 年间，共有 2645 名葡萄膜黑色素瘤患者（2648 只眼睛）接受了质子束放射治疗。数据分析截至2001年2月。患者年龄从9岁到90岁不等，其中男性1284人，女性1361人。最大肿瘤直径为4至27.5毫米，肿瘤高度为0.9至15.6毫米。中位随访时间为 44 个月。 结果：治疗后 5 年、10 年和 15 年的总体视力保留率分别为 88.9%、86.2% 和 83.7%。总共有 218 只眼睛被摘除。摘除与肿瘤体积较大有关，主要是肿瘤高度、肿瘤后缘距视盘的距离、男性、高眼压、治疗时视网膜脱离程度大。经过优化治疗技术后，小肿瘤的5年视力保留率从97.1%提高到100%，中型肿瘤从86.7%提高到99.7%，大肿瘤从71.1%提高到89.5%。结论：目前使用的治疗技术即使在大肿瘤和靠近视盘的肿瘤等不太有利的情况下也能获得优异的视力保留率。这些经验和持续的质量控制计划使我们能够提高所有肿瘤大小的 5 年眼睛保留率。这些发现证明了基于经验和质量控制的努力对治疗技术优化的积极影响。 (C) 2003 爱思唯尔科学公司。
Purpose: To analyze the long-term results of eye retention after conservative treatment of uveal melanoma with proton beam radiotherapy, and to analyze the causes leading to enucleation after this conservative treatment approach.Methods and Materials: This was a prospective, noncomparative, interventional, consecutive case series. A total of 2645 patients (2648 eyes) with uveal melanoma were treated between 1984 and 1999 with proton beam radiotherapy. Data were analyzed as of February 2001. Patients' age ranged from 9 to 90 years, 1284 were men, and 1361 were women. Largest tumor diameter ranged from 4 to 27.5 mm, and tumor height from 0.9 to 15.6 mm. Median follow-up time was 44 months.Results: The overall eye retention rate at 5, 10, and 15 years after treatment was 88.9%, 86.2%, and 83.7%, respectively. In total, 218 eyes had to be enucleated. Enucleation was related to larger tumor size, mainly tumor height, proximity of posterior tumor margin to optic disc, male gender, high intraocular pressure, and large degree of retinal detachment at treatment time. After optimization of the treatment technique, the eye retention rate at 5 years was increased from 97.1% to 100% for small tumors, from 86.7% to 99.7% for medium, and from 71.1% to 89.5% for large tumors.Conclusions: The treatment technique-as used today results in excellent eye retention rates, even in less favorable cases such as large tumors and tumors located close to the optic disc. The experience and a continuous quality control program allowed us to improve the 5-year eye retention rate for all tumor sizes. These findings demonstrate the positive impact of experience and quality control-based efforts for treatment technique optimization. (C) 2003 Elsevier Science Inc.