γ-刀立体定向治疗脉络膜黑色素瘤疗效观察  

Theγ-knife treatment for choroldal melanoma

作　　者：杨培学[1] 杨新爱 杨智华[1] 

机构地区：[1]新乡医学院第一附属医院眼科,河南省新乡453100 [2]河南省郸城县人民医院眼科

出　　处：《临床眼科杂志》2006年第3期193-195,共3页Journal of Clinical Ophthalmology

摘　　要：目的观察伽玛(γ)立体定向放射治疗(简称γ-刀治疗)脉络膜黑色素瘤的疗效。方法采用γ-刀治疗16例(16只眼)脉络膜黑色素瘤,40%～50%等剂量曲线覆盖肿瘤,肿瘤边缘剂量12～30 Gy。平均17 Gy,中心剂量35～68 Gy,平均48 Gy,γ角45o～65o。治疗后随访3～36个月,平均随访时间18.5个月。根据自觉症状、CT和MRI检查结果判断其治疗效果。结果症状好转8例,无变化6例。恶化2例,总有效率87.5%。CT和MRI等影像学检查显示肿瘤消失3例,缩小7例,无变化4例,2例肿瘤增大而行眼球摘除手术。除视网膜前及视网膜下可见小片状出血外,无其它严重并发症。结论γ-刀治疗脉络膜黑色素瘤瘤体局部控制率高,无严重并发症；是一种无创、安全、有效的脉络膜黑色素瘤治疗方法。Objective To evaluate the effect of the gamma knife on choroldal melanoma. Methods Sixteen patients with choroldal melanoma were treated by gamma knife radiosurgery. The edge isedose line range from 40% to 50%. The tumor margin dose was 12 - 30Gy（ mean 17Gy）, the tumor center dose was 35 - 68Gy, （ mean 48Gy）, γ-angle ranging from 45°to 65°. Results All the patients were followed up 3 - 36 months（ mean 18.5 months） post operatively. Symptoms improvement（ n =8）, no change（ n =6） and deterioration（ n =2） were found during following up period, the tumor control rate was 81.25% ; Based on follow up imaging studies,tumors disappeared in 3 cases, signs decreased in 7 cases, no change in 4 cases,enucleation was performed in 2 cases because of increase in size. There were no marked side effects except small hemorrhages in or under the retina. Conclusions Gamma knife radiosurgeryis a safe and effective non-invasive approach in treatment of choroldal melanoma, and no significant complications are found. There is a higher rate of local con- trol.

关 键 词：脉络膜黑色素瘤 伽玛刀 

分 类 号：R739.7[医药卫生—肿瘤] R651.12[医药卫生—临床医学]