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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Hypofractionated stereotactic photon radiotherapy of posteriorly located choroidal melanoma with five fractions at ten Gy - Clinical results after six years of experience
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Hypofractionated stereotactic photon radiotherapy of posteriorly located choroidal melanoma with five fractions at ten Gy - Clinical results after six years of experience

机译：后部脉络膜黑色素瘤的超分割立体定向光子放射治疗，在十个Gy时有五个分数-六年经验后的临床结果

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Purpose To evaluate long-term safety and efficacy of hypofractionated stereotactic photon radiotherapy with 5 five fractions at 10 Gy each in patients with centrally located choroidal melanoma. Materials and Methods Ninety-one patients with centrally located choroidal melanoma were treated stereotactically at a linear accelerator with 6 MV photon beams with 5 fractions at 10 Gy each. Examinations were performed at baseline and every 3 months in the first 2 years, then every 6 months until 5 years and yearly thereafter. Median follow-up was 37.8 months (IQR 19.2-49.9). They included visual acuity assessment, routine ophthalmological examinations with fundoscopy, echography for measurement of tumor dimensions, medical examinations and, if necessary, fluorescein angiography. Results Initial tumor base diameters, height and volume were 11.20 mm (IQR 9.10-13.70), 9.80 mm (IQR 7.80-11.70), 4.53 mm (IQR 3.33-6.43) and 253.8 mm3 (IQR 127.5-477.0). Local tumor control and eye retention rates were 97.7% and 86.4% after 5 years, respectively. Eight patients developed metastatic disease and 3 of them died due to metastatic disease during the follow-up period. Median visual acuity decreased from 0.67 initially to 0.05 at the last individual follow-up (p 0.001). The most common toxicities (any grade) were radiation retinopathy (n = 39), optic neuropathy (n = 32), radiogenic cataract (n = 21), neovascular glaucoma (n = 15) and dry eye syndrome (n = 10). The 5 year probabilities to remain free of these side effects (any grade) were 26.0%, 45.4%, 55.4%, 72.6% and 80.5%, respectively. The most important prognostic factors for toxicities were the largest tumor base diameter, tumor height and tumor distance to the optic disk. Conclusion Hypofractionated stereotactic photon radiotherapy with a total dose of 50 Gy delivered in 5 fractions is a highly effective treatment option in patients with centrally located choroidal melanoma and has a moderate toxicity profile.
机译：目的评估在中心定位的脉络膜黑色素瘤患者中进行5次5次，每次10 Gy的超分割立体定向光子放疗的长期安全性和有效性。材料与方法对91名位于中心的脉络膜黑色素瘤患者在线性加速器上以6 MV光子束进行立体定位，每束10 Gy分为5个组分。在基线时进行检查，在最初的2年中每3个月进行一次检查，然后每6个月进行一次检查，直到5年为止，之后每年进行检查。中位随访时间为37.8个月（IQR 19.2-49.9）。他们包括视力评估，使用眼底镜进行的常规眼科检查，用于测量肿瘤尺寸的回波描记术，医学检查以及必要时进行的荧光素血管造影。结果初始肿瘤的基础直径，高度和体积分别为11.20 mm（IQR 9.10-13.70），9.80 mm（IQR 7.80-11.70），4.53 mm（IQR 3.33-6.43）和253.8 mm3（IQR 127.5-477.0）。五年后局部肿瘤控制率和眼睛保留率分别为97.7％和86.4％。在随访期间，八名患者发生转移性疾病，其中三人死于转移性疾病。中位视力从最初的0.67下降到最后一次个体随访时的0.05（p <0.001）。最常见的毒性（任何级别）是放射性视网膜病变（n = 39），视神经病变（n = 32），放射性白内障（n = 21），新生血管性青光眼（n = 15）和干眼症（n = 10）。保持这些副作用（任何级别）的5年概率分别为26.0％，45.4％，55.4％，72.6％和80.5％。毒性最重要的预后因素是最大的肿瘤基底直径，肿瘤高度和肿瘤到视盘的距离。结论总分50戈瑞的分次立体定向光子放射治疗分5步进行，是中心性脉络膜黑色素瘤患者的一种高度有效的治疗选择，毒性中等。

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