质子束放射治疗脉络膜黑色素瘤的随访分析

发布时间：2018-08-03 17:22

【摘要】：目的：了解脉络膜黑色素瘤（Choroidal melanoma,CM）患者质子束放射治疗（proton beam therapy,PBT）后的临床效果方法：对1993年8月~2011年7月期间61例CM进行回顾性研究，所有病例均由法国斯特拉斯堡Nouvel h pital Civil (NHC)医院诊断并在结膜下放置4枚钽标记物，由尼斯放疗中心行PBT治疗3次，连续3天完成，总剂量60Gy，NHC医院随访。其中男性33例，女性28例。最大年龄87岁，最小年龄17岁。随访1月~11年。记录PBT治疗前后的视力、肿瘤厚度和基底最大直径变化，放疗后并发症及处理，以判断PBT治疗效果。结果：经PBT治疗61例CM病人中无死亡病例，1例严重并发症，4例肿瘤局部复发，3例CM肝转移。随访1个月、6个月、1年、3年、5年和10年的平均肿瘤厚度均小于PBT治疗前的平均值，平均肿瘤最大基底直径无明显变化。随访1个月、1年、3年、5年、10年的视力变化，分别有72.5%、75%、52.5%、40%、37.5%的患眼视力大于0.1。PBT治疗后出现放射性视网膜病变22例（36%），虹膜红变12例（19.7%），玻璃体出血11例（18%），新生血管性青光眼8例（13%），白内障7例（11.5%）。眼球摘除5例（8.2%），其肿瘤平均厚度和平均最大基底直径明显大于61例CM的平均值。肝转移3例（4.9%），远处转移和局部肿瘤的有效控制不相关。结论：从临床效果、眼球保留率和肿瘤远处转移率可证明PBT治疗中等大小CM是安全有效的。
[Abstract]:Objective: to investigate the clinical effect of proton beam radiotherapy on Choroidal melanoma after (proton beam therapy. Methods: a retrospective study of 61 cases of CM from August 1993 to July 2011 was conducted. All the patients were diagnosed by Nouvel h pital Civil (NHC) Hospital in Strasbourg, France and placed 4 tantalum markers under conjunctiva. The patients were treated with PBT three times by Nice radiotherapy Center. There were 33 males and 28 females. The maximum age is 87 and the youngest is 17. All patients were followed up from 1 month to 11 years. The changes of visual acuity, tumor thickness and maximum basal diameter before and after PBT treatment, complications and management after radiotherapy were recorded to judge the therapeutic effect of PBT. Results: among 61 cases of CM treated with PBT, 1 case had severe complication and 4 cases had local recurrence and 3 cases of CM liver metastasis. The mean tumor thickness of 1 month, 6 months, 1 year, 3 years, 5 years and 10 years follow-up was less than that before PBT treatment. All patients were followed up for 1 month, 1 year, 3 years, 5 years and 10 years. The visual acuity of 72.5% eyes was better than that of 0.1.PBT treatment in 22 cases (36%), iris redness in 12 cases (19.7%), vitreous hemorrhage in 11 cases (18%), neovascularization in 8 cases (13%), cataract in 7 cases (11.5%). In 5 cases (8.2%) of enucleation, the mean tumor thickness and mean maximum basal diameter were significantly larger than the mean value of CM in 61 cases. Liver metastasis was found in 3 cases (4.9%). Distant metastasis was not related to effective control of local tumor. Conclusion: the clinical effect, eyeball retention rate and distant metastasis rate of tumor can prove that PBT is safe and effective in the treatment of medium size CM.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R739.7

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