JAMA ophthalmology · 2014
Plaque radiotherapy for juxtapapillary choroidal melanoma: treatment complications and visual outcomes in 650 consecutive cases.
Оценочное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Sagoo Mandeep S, Shields Carol L, Emrich Jacqueline, Mashayekhi Arman, Komarnicky Lydia, Shields Jerry A
Аннотация
IMPORTANCE: The treatment of juxtapapillary choroidal melanoma is challenging because of the proximity of the tumor to visually important structures.
OBJECTIVE: To report the complications of treatment of juxtapapillary choroidal melanoma with plaque radiotherapy.
DESIGN, SETTING, AND PARTICIPANTS: In this retrospective case series of patients from the Ocular Oncology Service, Wills Eye Hospital, 650 consecutive eyes with juxtapapillary choroidal melanoma (≤1 mm to optic disc) treated with plaque radiotherapy from October 1, 1974, through November 30, 2005, were studied.
MAIN OUTCOMES AND MEASURES: Kaplan-Meier analysis of rates of radiation complications, secondary enucleation, and visual acuity outcomes.
RESULTS: The 5-year (10-year) rate of nonproliferative retinopathy was 66% (75%); proliferative retinopathy, 24% (32%); maculopathy, 56% (65%); papillopathy, 61% (77%); cataract, 66% (80%); neovascular glaucoma, 15% (22%); vitreous hemorrhage, 35% (42%); and secondary enucleation, 16% (26%). Visual acuity of 20/200 or worse occurred in 54% (87%), and loss of more than 5 lines of Snellen visual acuity was found in 45% (78%).
CONCLUSIONS AND RELEVANCE: Among this case series, plaque radiotherapy for juxtapapillary choroidal melanoma commonly led to retinopathy and papillopathy, but globe retention was 84% at 5 years. Vision loss should be anticipated in 45% by 5 years. Plaque radiotherapy remains a suitable choice for the treatment of juxtapapillary melanoma with a high globe retention rate.
OBJECTIVE: To report the complications of treatment of juxtapapillary choroidal melanoma with plaque radiotherapy.
DESIGN, SETTING, AND PARTICIPANTS: In this retrospective case series of patients from the Ocular Oncology Service, Wills Eye Hospital, 650 consecutive eyes with juxtapapillary choroidal melanoma (≤1 mm to optic disc) treated with plaque radiotherapy from October 1, 1974, through November 30, 2005, were studied.
MAIN OUTCOMES AND MEASURES: Kaplan-Meier analysis of rates of radiation complications, secondary enucleation, and visual acuity outcomes.
RESULTS: The 5-year (10-year) rate of nonproliferative retinopathy was 66% (75%); proliferative retinopathy, 24% (32%); maculopathy, 56% (65%); papillopathy, 61% (77%); cataract, 66% (80%); neovascular glaucoma, 15% (22%); vitreous hemorrhage, 35% (42%); and secondary enucleation, 16% (26%). Visual acuity of 20/200 or worse occurred in 54% (87%), and loss of more than 5 lines of Snellen visual acuity was found in 45% (78%).
CONCLUSIONS AND RELEVANCE: Among this case series, plaque radiotherapy for juxtapapillary choroidal melanoma commonly led to retinopathy and papillopathy, but globe retention was 84% at 5 years. Vision loss should be anticipated in 45% by 5 years. Plaque radiotherapy remains a suitable choice for the treatment of juxtapapillary melanoma with a high globe retention rate.
Предметные рубрики MeSH
AdultAgedAged, 80 and overBrachytherapyCataractChoroid NeoplasmsCohort StudiesEye EnucleationFemaleFollow-Up StudiesHumansKaplan-Meier EstimateMaleMelanomaMiddle AgedNeoplasm InvasivenessNeoplasm Recurrence, LocalNeoplasm StagingPredictive Value of TestsRadiation InjuriesRetinal DiseasesRetrospective StudiesRisk AssessmentTreatment OutcomeVisual AcuityVitreous Hemorrhage