■这项研究的目的是评估使用钌-106(106Ru)斑块进行近距离放射治疗以治疗葡萄膜黑色素瘤的功效和威胁视力的并发症。
■根据搜索PubMed的结果进行了文献综述,Embase,WebofScience,Scopus,和Cochrane数据库,使用以下关键词:“脉络膜黑色素瘤”,“葡萄膜黑色素瘤”,“近距离放射治疗”,和“钌-106”。我们纳入了自1986年以来对30多名患者进行的研究,报告了当地控制率,并发症发生率,平均辐射剂量,和平均肿瘤厚度。使用Statav.16的Metaprop命令进行累积分析,并根据平均肿瘤厚度和肿瘤顶点的平均辐射剂量进行荟萃回归。
■选择了21项回顾性研究,涉及3,913例主要接受106Ru斑块近距离放射治疗的患者。肿瘤顶点的辐射剂量范围为70Gy至250Gy。近距离放射治疗后的局部控制率为59%至98%,本地控制的总体加权平均值为84%。然而,研究报告之间的异质性是显著的(I2=95.40%)。基于肿瘤厚度和心尖辐射平均剂量的Meta回归显示,研究的异质性与平均肿瘤大小的差异最小相关(I2=92%)。较大的肿瘤大小与较低的局部控制率之间的相关性具有统计学意义(p值=0.024)。平均辐射剂量与局部控制率之间没有显着相关性(p值=0.679)。最常见的并发症是白内障和辐射相关性视网膜病变。
■尽管研究的异质性很高,在从70Gy到250Gy到肿瘤顶点的处方剂量中,106Ru近距离放射治疗似乎在局部控制葡萄膜黑色素瘤方面是成功的。106Ru控制葡萄膜黑色素瘤的功效随肿瘤厚度的增加而降低。然而,这些结局应在随机对比研究中得到验证.
UNASSIGNED: The aim of this study was to evaluate the efficacy and vision-threatening complications of brachytherapy with ruthenium-106 (106Ru) plaque to treat uveal melanoma.
UNASSIGNED: A literature
review was performed based on results from searching PubMed, Embase, Web of Science, Scopus, and Cochrane databases, using the following key words: \"choroidal melanoma\", \"uveal melanoma\", \"brachytherapy\", and \"ruthenium-106\". We included studies performed on more than 30 patients since 1986, reporting on local control rate, complications rate, mean radiation dose, and mean tumor thickness. The cumulative analysis was performed using Metaprop command of Stata v.16, and meta-regression was conducted based on mean tumor thickness and mean radiation dose to tumor\'s apex.
UNASSIGNED: Twenty-one retrospective studies were selected, involving 3,913 patients treated primarily with 106Ru plaque brachytherapy. The range of radiation dose to tumor apex was from 70 Gy to 250 Gy. The local control rate following brachytherapy ranged from 59% to 98%, and the overall weighted mean of local control was 84%. However, the heterogeneity between studies\' reports was remarkable (I 2 = 95.40%). Meta-regression based on tumor thickness and mean dose of radiation to the apex showed that the studies\' heterogeneity was minimally related to the difference in mean tumor size (I 2 = 92%). The correlation between larger tumor size and lower local control rate was statistically significant (p-value = 0.024). There was no significant correlation between the mean radiation dose and local control rate (p-value = 0.679). The most commonly reported complications were cataract and radiation-related retinopathy.
UNASSIGNED: Although the studies\' heterogeneity was high, in a prescription dose ranging from 70 Gy to 250 Gy to the tumor apex, 106Ru brachytherapy seems to be successful in local control of uveal melanoma. The efficacy of 106Ru in controlling uveal melanomas decreased with the increase in tumor thickness. However, these outcomes should be verified in randomized comparative studies.