Local tumor control after 106Ru brachytherapy of choroidal melanoma
Local tumor control after 106Ru brachytherapy of choroidal melanoma
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DOI：
10.1016/j.ijrobp.2005.02.017
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发表时间：
2005-10-01
影响因子：
7
通讯作者：
Errington, RD
中科院分区：
文献类型：
--
作者：
Damato, B;Patel, I;Errington, RD
目的：报告 Ru-106 近距离放射治疗脉络膜黑色素瘤后的局部肿瘤控制情况。方法和材料：1993 年 1 月至 2001 年 12 月期间，在同一机构总共治疗了 458 例脉络膜黑色素瘤患者。肿瘤的中位最长基底尺寸为 10.6 mm，中位高度为 3.2 mm。使用 15 或 20 毫米斑块进行近距离放射治疗。对于后肿瘤，斑块偏心放置，其后边缘与肿瘤后边缘对齐，以减少对视盘和中央凹的辐射剂量。足以引起可见脉络膜萎缩的最小巩膜剂量提供了脉络膜照射分布的永久检眼镜记录。如果不能确定是否对后肿瘤进行放疗，则术后6个月辅助进行经瞳孔热疗。结果：精算的2年、5年和7年肿瘤复发率分别为1%、2%和3%。局部肿瘤复发与最长基底肿瘤尺寸相关（Cox 单变量分析，p = 0.02，风险比 1.41，95% 置信区间 1.06-1.88）。 9只眼中复发肿瘤的7只眼通过额外的保守治疗得以挽救。结论：局部肿瘤复发率较低，表明钌斑块放疗在良好的病例选择和采取特殊措施确保斑块正确定位的情况下是有效的。 (c) 2005 年爱思唯尔公司。
Purpose: To report on local tumor control after Ru-106 brachytherapy for choroidal melanoma.Methods and Materials: A total of 458 patients with choroidal melanoma were treated at a single institution between January 1993 and December 2001. The tumors had a median longest basal dimension of 10.6 mm and a median height of 3.2 mm. The brachytherapy was administered using a 15- or 20-mm plaque. For posterior tumors, the plaque was positioned eccentrically with its posterior edge aligned with the posterior tumor margin to reduce the radiation dose to the optic disk and fovea. A minimal scleral dose sufficient to cause visible choroidal atrophy provided a permanent ophthalmoscopic record of the distribution of choroidal irradiation. If radiotherapy to the posterior tumor was uncertain, adjunctive transpupillary thermotherapy was administered 6 months postoperatively.Results: The actuarial rates of tumor recurrence were 1%, 2%, and 3% at 2, 5, and 7 years, respectively. Local tumor recurrence correlated with the longest basal tumor dimension (Cox univariate analysis, p = 0.02, risk ratio 1.41, 95% confidence interval 1.06-1.88). Seven of the nine eyes with recurrent tumor were salvaged with additional conservative therapy.Conclusion: The low rate of local tumor recurrence suggests that ruthenium plaque radiotherapy is effective with good case selection and if special measures are taken to ensure that the plaque is positioned correctly. (c) 2005 Elsevier Inc.