Plaque radiotherapy is an effective treatment modality for medium-sized ocular tumors such as uveal melanoma. The authors review the available literature and concisely summarize the current state of the art of ophthalmic plaque brachytherapy. The choice of radioisotope, which includes Ruthenium-106 and Iodine-125, depends on the intended treatment duration, tumor characteristics, and side effect profiles. Ophthalmic plaques may be customized to allow for the delivery of a precise radiation dose by adjusting seed placement and plaque shape to minimize collateral tissue radiation. High dose rate (HDR) brachytherapy, using beta (e.g., Yttrium-90) and photon-emitting sources (e.g., Ytterbium-169, Selenium-75), allows for rapid radiation dose delivery, which typically lasts minutes, compared to multiple days with low-dose plaque brachytherapy. The efficacy of Ruthenium-106 brachytherapy for uveal melanoma varies widely, with reported local control rates between 59.0% and 98.0%. Factors influencing outcomes include tumor size, thickness, anatomical location, and radiation dose at the tumor apex, with larger and thicker tumors potentially exhibiting poorer response and a higher rate of complications. Plaque brachytherapy is effective for selected tumors, particularly uveal melanoma, providing comparable survival rates to enucleation for medium-sized tumors. The complications of plaque brachytherapy are well described, and many of these are treatable.
斑块放射治疗是治疗中等大小眼内肿瘤（如葡萄膜黑色素瘤）的有效方法。本文作者回顾现有文献，简要总结了眼科斑块近距离放射治疗的最新进展。放射性同位素的选择（包括钌-106和碘-125）取决于预期治疗时长、肿瘤特征及副作用情况。眼科斑块可通过调整放射源排布和斑块形状进行定制化设计，以实现精准的辐射剂量投放，从而最大限度减少对周围组织的辐射损伤。高剂量率近距离放射治疗采用β射线源（如钇-90）和光子发射源（如镱-169、硒-75），可在数分钟内完成辐射剂量投放，而传统低剂量斑块近距离治疗通常需要数日。钌-106近距离治疗葡萄膜黑色素瘤的疗效差异显著，文献报道的局部控制率在59.0%至98.0%之间。影响治疗效果的因素包括肿瘤大小、厚度、解剖位置及肿瘤顶点的辐射剂量，其中体积较大、厚度较深的肿瘤可能表现出较差的治疗反应和较高的并发症发生率。对于特定肿瘤（尤其是葡萄膜黑色素瘤），斑块近距离放射治疗具有显著疗效，对中等大小肿瘤可达到与眼球摘除术相当的生存率。该治疗方式的并发症已有明确文献记载，且多数并发症可通过相应手段进行治疗。
肿瘤(癌症)患者之家