What treatment options are there for patients having uveal melanoma? A randomized, prospective, multi-institutional clinical trial (COMS) showed no difference in survival between brachytherapy and enucleation for medium-sized lesions. With the obvious benefit of retaining the eye, brachytherapy has flourished and many different approaches have been developed such as low-dose-rate sources using alternate low-energy photon-emitting radionuclides, different plaque designs and seed-loading techniques, high-dose-rate brachytherapy sources and applicators, and low- and high-dose-rate beta-emitting sources and applicators. There also have been developments of other radiation modalities like external-beam radiotherapy using linear accelerators with high-energy photons, particle accelerators for protons, and gamma stereotactic radiosurgery. This article examines the dosimetric properties, targeting capabilities, and outcomes of these approaches. The several modalities examined herein have differing attributes and it may be that no single approach would be considered optimal for all patients and all lesion characteristics.
葡萄膜黑色素瘤患者有哪些治疗选择？一项随机、前瞻性、多机构临床试验（COMS）显示，对于中等大小的病灶，近距离放射治疗与眼球摘除术在患者生存率方面无显著差异。鉴于保留眼球的显著优势，近距离放射治疗得到广泛应用，并发展出多种技术路径，包括采用替代性低能光子发射放射性核素的低剂量率放射源、不同形状的斑块设计与粒子植入技术、高剂量率近距离放射治疗源及其施源器，以及低剂量率与高剂量率β射线放射源及其施源器。其他放射治疗模式也取得进展，例如采用高能光子直线加速器的外照射放疗、质子粒子加速器治疗以及伽玛刀立体定向放射外科。本文系统评估了这些治疗方式的剂量学特性、靶向能力及临床疗效。研究表明，不同治疗模式具有各自特点，可能不存在适用于所有患者及所有病灶特征的单一最优方案。
Current and Emerging Radiotherapy Options for Uveal Melanoma
肿瘤(癌症)患者之家