Gamma knife radiosurgery for the treatment of uveal melanoma and uveal metastases

被引：10

作者：

Reynolds M.M. ^{[1
]}

Arnett A.L. ^{[2
]}

Parney I.F. ^{[3
]}

Kumar R. ^{[3
]}

Laack N.N. ^{[2
]}

Maloney P.R. ^{[3
]}

Kozelsky T.F. ^{[2
]}

Garces Y.I. ^{[2
]}

Foote R.L. ^{[2
]}

Pulido J.S. ^{[1
,4
]}

机构：

[1] Department of Ophthalmology, Mayo Clinic, 200 First Street, SW, Rochester, 55905, MN

[2] Department of Radiation Oncology, Mayo Clinic, Rochester, MN

[3] Department of Neurosurgery, Mayo Clinic, Rochester, MN

[4] Department of Molecular Medicine, Mayo Clinic, 200 First Street, SW, Rochester, 55905, MN

来源：

International Journal of Retina and Vitreous | / 3卷 / 1期

关键词：

Gamma knife; Intraocular metastasis; Stereotactic radiosurgery; Uveal melanoma; Uveal metastases;

D O I：

10.1186/s40942-017-0070-2

中图分类号：

学科分类号：

摘要：

Background: This study retrospectively analyzed outcomes for patients undergoing gamma knife radiosurgery (GKR) for uveal melanoma (UM) and intraocular metastases. Methods: Patients who underwent GKR for UM or intraocular metastases between 1/1/1990 and 6/1/2015 at Mayo Clinic, Rochester, MN, USA, were retrospectively analyzed. Results: Eleven patients (11 eyes) had UM while seven patients (7 eyes) had intraocular metastases. Patients with UM were followed for a median of 19.74 ± 10.4 months. Visual acuity (VA) logMAR 0.30 ± 0.53 (Snellen 20/40) versus 0.40 ± 0.97 (Snellen 20/50), tumor thickness (5.30 ± 2.17 vs. 3.60 ± 2.32 mm), were not significantly different between preoperative and postoperative measurements, respectively. Nine percent (1/11) patients required enucleation. Subsequently, no patients experienced metastases. Patients with intraocular metastases were followed for a median of 6.03 ± 6.32 months. They did not have significant changes in VA (logMAR 0.30 ± 0.59 vs. 0.30 ± 1.57; Snellen 20/40 vs. 20/40) or tumor thickness (3.50 ± 1.36 vs. 1.30 ± 0.76 mm) postoperatively. Fourteen percent (1/7 patients) required enucleation. Complications experienced by patients with UM include radiation retinopathy (2/11), papillopathy (1/11), cystoid macular edema (1/11), vitreomacular traction (1/11), exudative retinal detachment (1/11). Patients with metastases had treatment complicated by recurrence (2/7). Dose to the margin, maximum dose of radiation, and clinical target volume did not correlate with post-procedural VA, risk of enucleation, or death in patients with either UM or patients with intraocular metastases. Conclusions: Visual outcomes were satisfactory for patients undergoing GKR without significant morbidity and without significant risk of enucleation or metastases. © The Author(s) 2017.

引用

共 38 条

[1]

Modorati G., Miserocchi E., Galli L., Picozzi P., Rama P., Gamma knife radiosurgery for uveal melanoma: 12 years of experience, Br J Ophthalmol, 93, pp. 40-44, (2009)

[2]

Joye R.P., Williams L.B., Chan M.D., Witkin A.J., Schirmer C.M., Mignano J.E., Et al., Local control and results of Leksell gamma knife therapy for the treatment of uveal melanoma, Ophthalmic Surg Lasers Imaging Retina, 45, pp. 125-131, (2014)

[3]

Marchini G., Babighian S., Tomazzoli L., Gerosa M.A., Nicolato A., Bricolo A., Et al., Stereotactic radiosurgery of uveal melanomas: preliminary results with gamma knife treatment, Stereotact Funct Neurosurg, 64, pp. 72-79, (1995)

[4]

Chan M.D., Melhus C.S., Mignano J.E., Do-Dai D., Duker J.S., Yao K.C., Analysis of visual toxicity after gamma knife radiosurgery for treatment of choroidal melanoma: identification of multiple targets and mechanisms of toxicity, Am J Clin Oncol, 34, pp. 517-523, (2011)

[5]

Dinca E.B., Yianni J., Rowe J., Radatz M.W., Preotiuc-Pietro D., Rundle P., Et al., Survival and complications following gamma knife radiosurgery or enucleation for ocular melanoma: a 20-year experience, Acta Neurochir, 154, pp. 605-610, (2012)

[6]

Sarici A.M., Pazarli H., Gamma-knife-based stereotactic radiosurgery for medium-and large-sized posterior uveal melanoma, Graefes Arch Clin Exp Ophthalmol, 251, pp. 285-294, (2013)

[7]

Sikuade M.J., Salvi S., Rundle P.A., Errington D.G., Kacperek A., Rennie I.G., Outcomes of treatment with stereotactic radiosurgery or proton beam therapy for choroidal melanoma, Eye, 29, pp. 1194-1198, (2015)

[8]

Bellmann C., Fuss M., Holz F.G., Debus J., Rohrschneider K., Volcker H.E., Et al., Stereotactic radiation therapy for malignant choroidal tumors: preliminary, short-term results, Ophthalmology, 107, pp. 358-365, (2000)

[9]

Furdova A., Sramka M., Chorvath M., Kralik G., Krasnik V., Krcova I., Et al., Stereotactic radiosurgery in intraocular malignant melanoma-retrospective study, Neuro Endocrinol Lett, 35, pp. 28-36, (2014)

[10]

Suesskind D., Scheiderbauer J., Buchgeister M., Partsch M., Budach W., Bartz-Schmidt K.U., Et al., Retrospective evaluation of patients with uveal melanoma treated by stereotactic radiosurgery with and without tumor resection, JAMA Ophthalmol, 131, pp. 630-637, (2013)

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