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为提高脉络膜恶性黑色瘤的肿瘤控制率并保留患眼及其部分视力探索一条新的治疗途径 ,评价立体定向放射治疗作为脉络膜恶性黑色素瘤治疗方法的价值。方法 11例脉络膜恶性黑色素瘤患者中单次立体定向放射治疗 2例 ,分次立体定向放射治疗 9例 ;中心 1～ 2个 ,准直器 15～ 40mm ,参考剂量曲线 70 %～ 90 %。单次治疗DT2 5 0 0cGy 次和DT3 5 0 0cGy 次 ,分次治疗DT75 0 y～ 15 0 0cGy 次 ,2～ 4次 ,10～ 15d。结果 中位随访期 30个月 (随访 10～ 43个月内全部患者生存 )。 6例患者保留眼球和部分视力 ,肿瘤缩小或消失 ;5例患者因肿瘤未控 (1例 )、继发性青光眼 (2例 ) ,角膜溃疡 (2例 )而摘除眼球。全部患者未发现远地转移。结论 立体定向放射治疗对眼球后极或后部脉络膜恶性黑色素瘤是一种有效的治疗方法 ,部分患者达到既控制肿瘤又保留眼球和部分视力的目的。
In order to improve the tumor control rate of choroidal malignant melanoma and retain a new therapeutic approach for the eyes and part of their vision, the value of stereotactic radiotherapy as a treatment method for choroidal melanoma is evaluated. Methods 11 cases of choroidal melanoma patients were treated with single stereotactic radiotherapy in 2 cases, graded stereotactic radiotherapy in 9 cases, center 1~2, collimator 15 ~ 40mm, reference dose curve 70% ~ 90%. A single treatment of DT2500cGy and DT35000Gy times, divided treatment DT75 0 y ~ 15 0 0cGy times, 2 ~ 4 times, 10 ~ 15d. Results The median follow-up period was 30 months (All patients survived within 10-43 months of follow-up). In 6 patients, the eyeball and partial vision were preserved, and the tumors were reduced or disappeared; 5 patients had their eyes removed due to uncontrolled tumor (1 case), secondary glaucoma (2 cases), and corneal ulcer (2 cases). All patients did not find distant metastasis. Conclusion Stereotactic radiotherapy is an effective treatment for retro-orbital or posterior choroidal melanoma. Some patients achieve the goal of both controlling the tumor and retaining the eyeball and partial vision.