PDF(Pubmed)
Abstract：
UNASSIGNED: Stereotactic radiotherapy (SRT) in the treatment of choroidal melanoma (CM) may be indicated if the tumour is located close to the optic nerve or is unsuitable for a radiotherapeutic plaque. It is thought that the rate of visual decline and ocular sequelae with SRT is influenced by dose and location of radiation in relation to important visual structures. This study therefore aimed to look at these prognoses with respect to localisation and dose of radiation when treatment of CM with SRT occurs.
UNASSIGNED: A retrospective data analysis was conducted on all patients at Dunedin Hospital (DH) from August 2001 to May 2017 who were followed up for 4 years. SRT consisted of 50 Gy divided into five fractions over 5 days to tumours, with 2-mm treatment margins. The primary outcome measure was retention of functional vision - better than hand movements (HMs) within the treated eye. Secondary outcome measures included time to non-functional vision (HM or less) in relation to location, dose and tumour thickness, the presence of radiation retinopathy, local and metastatic tumour progression, enucleation, and disease-specific mortality.
UNASSIGNED: Seventy-five patients were identified in this study. Follow-up was incomplete in 10 patients, and 4 patients became deceased within the 4-year study period. Twenty-nine patients (48%) retained visual acuity (VA) better than HMs in the treated eye at 4 years, and thirty-two (52%) of patients did not. Calculated dose to the optic nerve and macula and proximity of the tumour to the optic nerve and macula were not statistically determinative of vision outcomes, although presenting VA was. Fifty-six per cent of patients developed radiation retinopathy involving the macula. The local progression, metastatic progression and enucleation rates were 4.6%, 6%, and 12.3%, representing 3, 4, and 8 patients, respectively.
UNASSIGNED: This study demonstrates that approximately half of patients treated with SRT can expect to maintain functional vision better than HM at 4 years. The rate of visual decline and final vision outcome are independent of location of the tumour in relation to the optic nerve and macula. While it affirms that SRT achieves high rates of local tumour control and eye retention, preservation of functional VA remains an unpredictable endpoint for individual cases and highlights the therapeutic challenge of this treatment modality.
UNASSIGNED: A retrospective data analysis was conducted on all patients at Dunedin Hospital (DH) from August 2001 to May 2017 who were followed up for 4 years. SRT consisted of 50 Gy divided into five fractions over 5 days to tumours, with 2-mm treatment margins. The primary outcome measure was retention of functional vision - better than hand movements (HMs) within the treated eye. Secondary outcome measures included time to non-functional vision (HM or less) in relation to location, dose and tumour thickness, the presence of radiation retinopathy, local and metastatic tumour progression, enucleation, and disease-specific mortality.
UNASSIGNED: Seventy-five patients were identified in this study. Follow-up was incomplete in 10 patients, and 4 patients became deceased within the 4-year study period. Twenty-nine patients (48%) retained visual acuity (VA) better than HMs in the treated eye at 4 years, and thirty-two (52%) of patients did not. Calculated dose to the optic nerve and macula and proximity of the tumour to the optic nerve and macula were not statistically determinative of vision outcomes, although presenting VA was. Fifty-six per cent of patients developed radiation retinopathy involving the macula. The local progression, metastatic progression and enucleation rates were 4.6%, 6%, and 12.3%, representing 3, 4, and 8 patients, respectively.
UNASSIGNED: This study demonstrates that approximately half of patients treated with SRT can expect to maintain functional vision better than HM at 4 years. The rate of visual decline and final vision outcome are independent of location of the tumour in relation to the optic nerve and macula. While it affirms that SRT achieves high rates of local tumour control and eye retention, preservation of functional VA remains an unpredictable endpoint for individual cases and highlights the therapeutic challenge of this treatment modality.
摘要：
■如果肿瘤位于视神经附近或不适合放射治疗斑块，则可能需要在脉络膜黑色素瘤（CM）治疗中进行立体定向放射治疗（SRT）。据认为，SRT的视力下降率和眼部后遗症受与重要视觉结构相关的辐射剂量和位置的影响。因此，本研究旨在研究在用SRT治疗CM时有关放射定位和放射剂量的这些预后。
■对2001年8月至2017年5月在但尼丁医院（DH）随访4年的所有患者进行了回顾性数据分析。SRT由50Gy组成，在5天内分成5个部分到肿瘤，2毫米的治疗边缘。主要结果指标是保留功能视力-优于治疗眼睛内的手部运动（HM）。次要结局指标包括与位置相关的非功能性视力时间（HM或更少），剂量和肿瘤厚度，放射性视网膜病变的存在，局部和转移性肿瘤进展，摘除,和疾病特异性死亡率。
■在这项研究中确定了75名患者。10例患者随访不完整，4名患者在4年研究期内死亡.29名患者（48％）在4年的治疗眼中保持视力（VA）优于HM，32例（52%）患者没有。视神经和黄斑的计算剂量以及肿瘤与视神经和黄斑的接近度在统计学上不能确定视力结果。虽然介绍VA是。56％的患者出现了涉及黄斑的放射性视网膜病变。当地的进步，转移进展和摘除率为4.6%,6%,12.3%，代表3、4和8名患者，分别。
■这项研究表明，大约一半接受SRT治疗的患者在4年时可以预期比HM更好地维持功能视力。视力下降率和最终视力结果与肿瘤相对于视神经和黄斑的位置无关。虽然它肯定SRT实现了高的局部肿瘤控制率和眼部保留率，对于个别病例来说,保留功能性VA仍然是一个不可预测的终点,并突出了这种治疗方式的治疗挑战.
■对2001年8月至2017年5月在但尼丁医院（DH）随访4年的所有患者进行了回顾性数据分析。SRT由50Gy组成，在5天内分成5个部分到肿瘤，2毫米的治疗边缘。主要结果指标是保留功能视力-优于治疗眼睛内的手部运动（HM）。次要结局指标包括与位置相关的非功能性视力时间（HM或更少），剂量和肿瘤厚度，放射性视网膜病变的存在，局部和转移性肿瘤进展，摘除,和疾病特异性死亡率。
■在这项研究中确定了75名患者。10例患者随访不完整，4名患者在4年研究期内死亡.29名患者（48％）在4年的治疗眼中保持视力（VA）优于HM，32例（52%）患者没有。视神经和黄斑的计算剂量以及肿瘤与视神经和黄斑的接近度在统计学上不能确定视力结果。虽然介绍VA是。56％的患者出现了涉及黄斑的放射性视网膜病变。当地的进步，转移进展和摘除率为4.6%,6%,12.3%，代表3、4和8名患者，分别。
■这项研究表明，大约一半接受SRT治疗的患者在4年时可以预期比HM更好地维持功能视力。视力下降率和最终视力结果与肿瘤相对于视神经和黄斑的位置无关。虽然它肯定SRT实现了高的局部肿瘤控制率和眼部保留率，对于个别病例来说,保留功能性VA仍然是一个不可预测的终点,并突出了这种治疗方式的治疗挑战.
