PDF(Pubmed)
Abstract：
UNASSIGNED: To describe a pilot study on the use of single-session, high-dose-rate, Food and Drug Administration-cleared, yttrium-90 (Y90) plaque brachytherapy for iris and iridociliary melanoma.
UNASSIGNED: A single-center, clinical case series.
UNASSIGNED: Six consecutive patients were included in this study. Each was diagnosed with an iris or iridociliary melanoma based on clinical examination with or without biopsy.
UNASSIGNED: Each tumor was staged according to the American Joint Committee on Cancer criteria and received Y90 eye plaque brachytherapy. The main variables were tumor size, patient age, sex, and method of diagnosis (clinical or biopsy). Surgical techniques, treatment durations, and ocular side effects were recorded. Local control was defined as a lack of tumor growth or regression determined by clinical examinations, including slit-lamp and gonio photography, as well as high-frequency ultrasound measurements. Toxicity parameters included acute and short-term corneal/scleral change, anterior segment inflammation, and cataract progression.
UNASSIGNED: Local and systemic cancer control, tumor regression, visual acuity, as well as radiation-related normal tissue toxicity.
UNASSIGNED: High-dose-rate Y90 plaque brachytherapy was used to treat small (American Joint Committee on Cancer cT1) category melanomas. Single-surgery high-dose-rate irradiations were performed under anesthesia. Because of short treatment durations, high-dose-rate Y90 did not require the additional procedures used for low-dose-rate plaque (e.g., sutures, amniotic membrane epicorneal buffering, Gunderson flaps, and second surgeries for plaque removal). Only conjunctival recession was used to avoid normal tissue irradiation. High-dose-rate Y90 treatment durations averaged 8.8 minutes (median, 7.9; range, 5.8-12.9). High-dose-rate Y90 brachytherapy was associated with no periorbital, corneal (Descemet folds), or conjunctival edema. There was no acute or short-term anterior uveitis, secondary cataract, scleropathy, radiation retinopathy, maculopathy, or optic neuropathy. The follow-up was a mean of 16.0 (range 12-24) months. Evidence of local control included a lack of expansion of tumor borders (n = 6, 100%), darkening with or without atrophy of the tumor surface (n = 5/6, 83%), and a mean 24.5% reduction in ultrasonographically measured tumor thickness. There were no cases of metastatic disease.
UNASSIGNED: High-dose-rate Y90 brachytherapy allowed for single-surgery, minimally invasive, outpatient irradiation of iris and iridociliary melanomas.
UNASSIGNED: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
UNASSIGNED: A single-center, clinical case series.
UNASSIGNED: Six consecutive patients were included in this study. Each was diagnosed with an iris or iridociliary melanoma based on clinical examination with or without biopsy.
UNASSIGNED: Each tumor was staged according to the American Joint Committee on Cancer criteria and received Y90 eye plaque brachytherapy. The main variables were tumor size, patient age, sex, and method of diagnosis (clinical or biopsy). Surgical techniques, treatment durations, and ocular side effects were recorded. Local control was defined as a lack of tumor growth or regression determined by clinical examinations, including slit-lamp and gonio photography, as well as high-frequency ultrasound measurements. Toxicity parameters included acute and short-term corneal/scleral change, anterior segment inflammation, and cataract progression.
UNASSIGNED: Local and systemic cancer control, tumor regression, visual acuity, as well as radiation-related normal tissue toxicity.
UNASSIGNED: High-dose-rate Y90 plaque brachytherapy was used to treat small (American Joint Committee on Cancer cT1) category melanomas. Single-surgery high-dose-rate irradiations were performed under anesthesia. Because of short treatment durations, high-dose-rate Y90 did not require the additional procedures used for low-dose-rate plaque (e.g., sutures, amniotic membrane epicorneal buffering, Gunderson flaps, and second surgeries for plaque removal). Only conjunctival recession was used to avoid normal tissue irradiation. High-dose-rate Y90 treatment durations averaged 8.8 minutes (median, 7.9; range, 5.8-12.9). High-dose-rate Y90 brachytherapy was associated with no periorbital, corneal (Descemet folds), or conjunctival edema. There was no acute or short-term anterior uveitis, secondary cataract, scleropathy, radiation retinopathy, maculopathy, or optic neuropathy. The follow-up was a mean of 16.0 (range 12-24) months. Evidence of local control included a lack of expansion of tumor borders (n = 6, 100%), darkening with or without atrophy of the tumor surface (n = 5/6, 83%), and a mean 24.5% reduction in ultrasonographically measured tumor thickness. There were no cases of metastatic disease.
UNASSIGNED: High-dose-rate Y90 brachytherapy allowed for single-surgery, minimally invasive, outpatient irradiation of iris and iridociliary melanomas.
UNASSIGNED: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
摘要：
■为了描述关于使用单会话的试点研究，高剂量率，食品和药物管理局批准，钇-90（Y90）斑块近距离放射治疗虹膜和虹膜睫状黑色素瘤。
■单中心，临床病例系列。
■本研究包括6名连续患者。根据有或没有活检的临床检查，每个人都被诊断为虹膜或虹膜睫状黑色素瘤。
■根据美国癌症联合委员会标准对每个肿瘤进行分期，并接受Y90眼斑块近距离放射治疗。主要变量是肿瘤大小，患者年龄,性别,和诊断方法（临床或活检）。外科技术,治疗持续时间,并记录眼部副作用。局部控制被定义为缺乏肿瘤生长或通过临床检查确定的消退。包括裂隙灯和gonio摄影，以及高频超声测量。毒性参数包括急性和短期角膜/巩膜改变，眼前节炎症,和白内障进展。
■局部和全身癌症控制，肿瘤消退，视敏度,以及辐射相关的正常组织毒性。
■高剂量率Y90斑块近距离放射治疗用于治疗小型（美国癌症联合委员会cT1）类别的黑色素瘤。在麻醉下进行单次手术高剂量率照射。由于治疗持续时间短，高剂量率Y90不需要用于低剂量率斑块的额外程序(例如，缝线,羊膜内膜缓冲，Gunderson襟翼,和第二次手术去除斑块)。仅使用结膜凹陷来避免正常组织照射。高剂量率Y90治疗持续时间平均8.8分钟（中位数，7.9；范围，5.8-12.9)。高剂量率Y90近距离放射治疗与眶周无关，角膜（Descemet折叠），或结膜水肿。没有急性或短期的前葡萄膜炎，继发性白内障，巩膜病变,放射性视网膜病变,黄斑病变,或者视神经病变.随访平均16.0个月（12-24个月）。局部控制的证据包括肿瘤边界缺乏扩张（n=6，100％），在有或没有肿瘤表面萎缩的情况下变暗（n=5/6，83％），超声测量的肿瘤厚度平均减少24.5%。没有转移性疾病的病例。
■允许单次手术的高剂量率Y90近距离放射治疗，微创,虹膜和虹膜睫状黑色素瘤的门诊照射。
■专有或商业披露可在本文末尾的脚注和披露中找到。
■单中心，临床病例系列。
■本研究包括6名连续患者。根据有或没有活检的临床检查，每个人都被诊断为虹膜或虹膜睫状黑色素瘤。
■根据美国癌症联合委员会标准对每个肿瘤进行分期，并接受Y90眼斑块近距离放射治疗。主要变量是肿瘤大小，患者年龄,性别,和诊断方法（临床或活检）。外科技术,治疗持续时间,并记录眼部副作用。局部控制被定义为缺乏肿瘤生长或通过临床检查确定的消退。包括裂隙灯和gonio摄影，以及高频超声测量。毒性参数包括急性和短期角膜/巩膜改变，眼前节炎症,和白内障进展。
■局部和全身癌症控制，肿瘤消退，视敏度,以及辐射相关的正常组织毒性。
■高剂量率Y90斑块近距离放射治疗用于治疗小型（美国癌症联合委员会cT1）类别的黑色素瘤。在麻醉下进行单次手术高剂量率照射。由于治疗持续时间短，高剂量率Y90不需要用于低剂量率斑块的额外程序(例如，缝线,羊膜内膜缓冲，Gunderson襟翼,和第二次手术去除斑块)。仅使用结膜凹陷来避免正常组织照射。高剂量率Y90治疗持续时间平均8.8分钟（中位数，7.9；范围，5.8-12.9)。高剂量率Y90近距离放射治疗与眶周无关，角膜（Descemet折叠），或结膜水肿。没有急性或短期的前葡萄膜炎，继发性白内障，巩膜病变,放射性视网膜病变,黄斑病变,或者视神经病变.随访平均16.0个月（12-24个月）。局部控制的证据包括肿瘤边界缺乏扩张（n=6，100％），在有或没有肿瘤表面萎缩的情况下变暗（n=5/6，83％），超声测量的肿瘤厚度平均减少24.5%。没有转移性疾病的病例。
■允许单次手术的高剂量率Y90近距离放射治疗，微创,虹膜和虹膜睫状黑色素瘤的门诊照射。
■专有或商业披露可在本文末尾的脚注和披露中找到。
