PDF(Pubmed)
Abstract：
UNASSIGNED: Uveal melanoma is the most common primary intraocular malignancy in adults, affecting primarily the choroid of the eye. Plaque brachytherapy is the most common procedure for the treatment of small choroidal melanoma, especially in posteriorly located tumors. However, modern radiotherapy techniques, such as CyberKnife or Gamma knife stereotactic radiosurgery (SRS) and proton beam radiotherapy, have shown better results in tumor control and eye retention. Recent studies have indicated that SRS is a promising non-invasive, single-session treatment option, with most studies reporting the best outcomes when using ≥21-22 Gy. However, there is no consistent protocol for managing this pathology using CyberKnife, not only in terms of dose but also fractions.
UNASSIGNED: Here, we report the first case series of patients (n = 4, age range 38-64 years, median age 52.5 years) with choroidal UM in Central America who were treated with CyberKnife SRS (22 Gy in one session). During the follow-up (range 25-29 months, median 27.5 months), a 100% control rate with no systemic metastatic disease has been achieved. We found a statistically significant reduction in the largest basal diameter at 24 months for all tumors. However, visual acuity has progressively decreased in most patients. Notably, two of our patients developed radiation maculopathy, and the other two developed radiation retinopathy after SRS.
UNASSIGNED: Our findings suggest that future studies should evaluate the use of different prophylactic therapies to prevent the development of side effects. The clinical management of toxicities presented in our report can serve as a reference in the clinical practice of other centers. Our report supports the growing body of evidence showing that CyberKnife radiosurgery is a safe and effective therapeutic option for the treatment of UM.
UNASSIGNED: Here, we report the first case series of patients (n = 4, age range 38-64 years, median age 52.5 years) with choroidal UM in Central America who were treated with CyberKnife SRS (22 Gy in one session). During the follow-up (range 25-29 months, median 27.5 months), a 100% control rate with no systemic metastatic disease has been achieved. We found a statistically significant reduction in the largest basal diameter at 24 months for all tumors. However, visual acuity has progressively decreased in most patients. Notably, two of our patients developed radiation maculopathy, and the other two developed radiation retinopathy after SRS.
UNASSIGNED: Our findings suggest that future studies should evaluate the use of different prophylactic therapies to prevent the development of side effects. The clinical management of toxicities presented in our report can serve as a reference in the clinical practice of other centers. Our report supports the growing body of evidence showing that CyberKnife radiosurgery is a safe and effective therapeutic option for the treatment of UM.
摘要：
■葡萄膜黑色素瘤是成人最常见的原发性眼内恶性肿瘤，主要影响眼睛的脉络膜。斑块近距离放射治疗是治疗小脉络膜黑色素瘤最常见的方法，尤其是位于后部的肿瘤。然而,现代放射治疗技术，如射波刀或伽玛刀立体定向放射外科（SRS）和质子束放射治疗，在肿瘤控制和眼部保留方面显示出更好的结果。最近的研究表明，SRS是一种有前途的非侵入性，单次治疗方案，大多数研究报告使用≥21-22Gy时的最佳结果。然而,没有使用射波刀来管理这种病理的一致方案，不仅在剂量方面，而且在分数方面。
■这里，我们报告了第一例系列患者(n=4，年龄范围38-64岁，中位年龄52.5岁）在中美洲接受射波刀SRS治疗的脉络膜UM（一次22Gy）。在随访期间(范围25-29个月，中位数27.5个月），已实现100%的控制率,且无全身性转移性疾病.我们发现，所有肿瘤在24个月时的最大基底直径均有统计学上的显着降低。然而,大多数患者的视力逐渐下降。值得注意的是,我们的两个病人出现了放射性黄斑病变,另外两个在SRS后出现放射性视网膜病变.
■我们的研究结果表明，未来的研究应该评估使用不同的预防性疗法来防止副作用的发展。我们报告中介绍的毒性的临床管理可作为其他中心临床实践的参考。我们的报告支持越来越多的证据表明，射波刀放射外科是治疗UM的安全有效的治疗选择。
■这里，我们报告了第一例系列患者(n=4，年龄范围38-64岁，中位年龄52.5岁）在中美洲接受射波刀SRS治疗的脉络膜UM（一次22Gy）。在随访期间(范围25-29个月，中位数27.5个月），已实现100%的控制率,且无全身性转移性疾病.我们发现，所有肿瘤在24个月时的最大基底直径均有统计学上的显着降低。然而,大多数患者的视力逐渐下降。值得注意的是,我们的两个病人出现了放射性黄斑病变,另外两个在SRS后出现放射性视网膜病变.
■我们的研究结果表明，未来的研究应该评估使用不同的预防性疗法来防止副作用的发展。我们报告中介绍的毒性的临床管理可作为其他中心临床实践的参考。我们的报告支持越来越多的证据表明，射波刀放射外科是治疗UM的安全有效的治疗选择。
