目的:介绍美国近距离放射治疗学会(ABS)脉络膜黑色素瘤和视网膜母细胞瘤的斑块近距离放射治疗指南。
方法:组建了一个国际多中心眼科肿瘤学工作组(OOTF),包括47名放射肿瘤学家,医学物理学家,和来自10个国家的眼科肿瘤学家。ABS-OOTF制定了合作指南,根据他们的眼部癌症特异性临床经验和文献知识。这项工作已由ABS董事会以及该杂志的同行评审过程进行了审查和批准。
结果:ABS-OOTF达成共识,认为眼科斑块放射治疗最好在亚专科近距离放射治疗中心进行。质量保证,斑块的构建方法,和剂量测定应符合2012年美国医学和ABS物理学家协会的联合指南。斑块来源的植入应由经过亚专科培训的外科医生进行。尽管存在与肿瘤大小和位置相关的选择限制,ABS-OOTF同意大多数虹膜黑色素瘤,睫状体,脉络膜可以用斑块近距离放射治疗。ABS-OOTF达成共识,认为患有眼眶扩张和失明疼痛的肿瘤以及没有光感知视力的肿瘤不适合近距离放射治疗。相比之下,只有部分视网膜母细胞瘤符合斑块近距离放射治疗的条件.处方剂量,剂量率,治疗持续时间,和临床方法进行了描述。
结论:斑块近距离放射治疗是治疗眼内肿瘤患者的一种有效的保留眼睛和视力的方法。鼓励从业者使用ABS-OOTF指南来加强他们的实践。
OBJECTIVE: To present the American Brachytherapy Society (ABS)
guidelines for
plaque brachytherapy of choroidal melanoma and retinoblastoma.
METHODS: An international multicenter Ophthalmic Oncology Task Force (OOTF) was assembled to include 47 radiation oncologists, medical physicists, and ophthalmic oncologists from 10 countries. The ABS-OOTF produced collaborative guidelines, based on their eye cancer-specific clinical experience and knowledge of the literature. This work was reviewed and approved by the ABS Board of Directors as well as within the journal\'s peer-reivew process.
RESULTS: The ABS-OOTF reached
consensus that ophthalmic
plaque radiation therapy is best performed in subspecialty brachytherapy centers. Quality assurance, methods of plaque construction, and dosimetry should be consistent with the 2012 joint
guidelines of the American Association of Physicists in Medicine and ABS. Implantation of plaque sources should be performed by subspecialty-trained surgeons. Although there exist select restrictions related to tumor size and location, the ABS-OOTF agreed that most melanomas of the iris, ciliary body, and choroid could be treated with plaque brachytherapy. The ABS-OOTF reached
consensus that tumors with gross orbital extension and blind painful eyes and those with no light perception vision are unsuitable for brachytherapy. In contrast, only select retinoblastomas are eligible for plaque brachytherapy. Prescription doses, dose rates, treatment durations, and clinical methods are described.
CONCLUSIONS: Plaque brachytherapy is an effective eye and vision-sparing method to treat patients with intraocular tumors. Practitioners are encouraged to use ABS-OOTF
guidelines to enhance their practice.