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目的探讨伽玛(γ)刀治疗脉络膜黑色素瘤的疗效。方法采用γ-刀治疗16例脉络膜黑色素瘤,40%-50%等剂量曲线覆盖肿瘤,肿瘤边缘剂量(12-30)Gy,平均17Gy,中心剂量(35-68)Gy,平均48Gy,γ角45°-65°。结果全部病例随访3m～36m,平均18.5m,其中症状好转8例,无变化6例,恶化2例,总有效率87.5%;影像学显示,肿瘤消失3例,缩小7例,无变化4例2例增大而行眼球摘除术;除视网膜及其膜下可见小片状出血外,无其它严重并发症。结论脉络膜黑色素瘤的γ-刀立体定向放射治疗是一种无创性、安全有效的方法,无严重并发症,瘤体局部控制率高。
Objective To investigate the efficacy of gamma knife in the treatment of choroidal melanoma. Methods 16 cases of choroidal melanoma were treated with γ-knife. The isograd curve was covered by 40% -50% dose. The marginal dose (12-30 Gy) of the tumor was averagely 17 Gy with a median dose of 35-68 Gy with an average of 48 Gy 45 ° -65 °. Results All cases were followed up for 3m ~ 36m, with an average of 18.5m, of which 8 were improved, 6 were unchanged, 2 were deteriorated, and the total effective rate was 87.5%. Imaging findings showed that tumor disappeared in 3, shrinking in 7 and no change in 4 2 cases of enucleation and enucleation; in addition to the retina and its subtotal small hemorrhage, no other serious complications. Conclusion γ-knife stereotactic radiotherapy of choroidal melanoma is a noninvasive, safe and effective method. There is no serious complications and the local control rate of the tumor is high.