文章：

质子束疗法治疗晚期眼周皮肤癌：一种保留视力的方法

Proton Beam Therapy for Advanced Periocular Skin Cancer: An Eye-Sparing Approach

原文发布日期：20 January 2025

DOI: 10.3390/cancers17020327

类型: Article

开放获取: 是

英文摘要：

Background/Objectives:The management of periocular skin malignancies presents a unique challenge. Proton beam therapy, due to its sharp dose fall-off, allows for the delivery of a tumoricidal dose to the tumor while sparing adjacent normal tissues.Methods:Thirteen patients with a median age of 76.5 years received protons at our institution to a median dose of 66.6 Gy (RBE). Sixty-four percent of the lesions were basal cell carcinoma, and 22% were squamous cell carcinoma. Eighty-six percent of patients underwent biopsy only or partial resection. Fifty-seven percent of the lesions were located in the medial or lateral canthus. There was orbital invasion in 93% of the cases. Locoregional control probability and overall survival were estimated with the Kaplan–Meier method. Treatment toxicity was scored using the CTCAE 4.0.Results:At a median follow-up of 96 months, there was no local recurrence. The rate of orbital preservation was 100%. Functional vision was maintained in all the patients. There was no acute or late grade 3 or higher toxicity.Conclusions:Protons allow for long-term tumor control with eye preservation in patients with locally advanced periocular skin cancers. Larger prospective multi-institutional trials with standardized ophthalmological assessments are needed to confirm our findings.

摘要翻译： 

背景/目的：眼周皮肤恶性肿瘤的治疗面临独特挑战。质子束疗法凭借其陡峭的剂量跌落特性，可在向肿瘤递送致死剂量的同时保护邻近正常组织。方法：13例中位年龄76.5岁的患者在我院接受中位剂量66.6 Gy（相对生物效应）的质子治疗。64%的病灶为基底细胞癌，22%为鳞状细胞癌。86%的患者仅接受活检或部分切除术。57%的病灶位于内眦或外眦区域。93%的病例存在眼眶侵犯。采用Kaplan-Meier法评估局部区域控制概率和总生存率。治疗毒性根据CTCAE 4.0标准进行分级。结果：中位随访96个月期间，所有病例均未出现局部复发。眼眶保留率达100%。所有患者均保持功能性视力。未发生急性或晚期3级及以上毒性反应。结论：质子治疗可为局部晚期眼周皮肤癌患者实现长期肿瘤控制并保留眼球功能。未来需要通过标准化眼科评估开展更大规模的前瞻性多中心试验以验证本研究结果。

原文链接：

Proton Beam Therapy for Advanced Periocular Skin Cancer: An Eye-Sparing Approach