LASER INDUCED HYPERTHERMIA TO TREAT CHOROIDAL MELANOMA

脉络膜黑色素瘤的正确治疗仍在争论中，但放射治疗 治疗(巩膜斑块或外束带电粒子)正在使用中 在越来越多的患者中作为主要治疗方法。次要的 眼部放射治疗的效果在几年后观察 治疗并可能导致视力显著下降。 辅以眼部热疗可减少电离剂量 消毒脉络膜黑色素瘤所需的放射治疗。如果生产的是 眼部热疗只能局限于肿瘤，然后减少 眼部照射的剂量可以反过来减轻继发性肺炎的严重程度 正常眼结构的并发症。 我们的目标是记录使用低功率、连续波的效果 (C.W.)作为一种精密高效眼科光源的Nd：YAG激光器 肿瘤热疗。低功率，C.W.激光将不会被用于 消融、切割或光凝术。相反，我们将利用 组织传输特性以及高效加热 C.W.的特点。石榴石激光器。经角膜输送的一种 YAG激光器产生的低功率红外光的发散光束 应该提供非常好的局部和可控的热疗 起源于脉络膜黑色素瘤的顶端。 移植了脉络膜绿黑色素瘤的有色兔将被 用于研究项目。将确定肿瘤的温度分布 作为激光功率密度和肿瘤组织深度的函数。眼球 激光治疗野内外的毒性反应 将体温升高进行检查并定量测定正常组织的剂量反应 将生成曲线。急性和慢性毒性将通过以下方式记录 眼底镜观察、眼底照相、荧光素血管造影术 组织病理学检查。定量剂量反应实验 也将进行比较巩膜斑块的有效性 (I-125)放射治疗以放射加热疗相结合。 各种治疗方法和剂量的有效性将从以下方面确定 肿瘤再生长和肿瘤治疗参数。

The correct treatment for choroidal melanoma is under debate, but radiation therapy (scleral plaques or external beam charged particles) is being used as the primary therapy in an increasing number of patients. Secondary effects of ocular radiation therapy are observed several years after treatment and can result in a significant decrease in visual acuity. Adjunctive use of ocular hyperthermia could reduce the dose of ionizing radiation needed to sterilize choroidal melanomas. If the production of ocular hyperthermia can be limited only to the tumor, then a reduction in the dose of ocular radiation could in turn reduce the severity of secondary complications to normal ocular structures. Our goal is to document the efficacy of using a low power, continuous wave (c.w.) Neodymium YAG laser as a source of precise and efficient ocullar tumor hyperthermia. The low power, c.w. YAG laser will not be used in an ablative, cutting or photocoagulation procedure. Rather, we will exploit the tissue transmission properties as well as efficient heating characteristics of the c.w. YAG laser. Trans-corneal delivery of a diverging beam of low power infra-red light generated from the YAG laser should provide extremely well localized and controlled hyperthermia originating at the apex off a choroidal melanoma. Pigmented rabbits with transplanted choroidal Greene's melanoma will be used in research projects. Tumor temperature profiles will be determined as a function of laser light power density and tumor tissue depth. Ocular toxicity (both in and out of the treatment field) induced by YAG laser hyperthermia will be examined and quantitative normal tissue dose response curves will be generated. Acute and chronic toxicity will be documented by ophthalmoscopic observation, fundus photography, fluorescein angiography and histopathological examination. Quantitative dose response experiments will also be performed to compare the effectiveness of scleral plaque (I-125) radiation therapy to a combination of radiation plus hyperthermia. The effectiveness of various treatments and doses will be determined from tumor regrowth and tumor cure parameters.