Introduction: The aim of this study was to elucidate the long-term outcomes in patients with choroidal melanoma who received episcleral brachytherapy with 125-I seeds; analyse cause-specific survival (CSS), metastasis-free survival (MFS), and local control; and establish the relationship between tumour size and metastases. Methods: From May 2007 to February 2013, 88 patients classified according to the American Joint Committee on Cancer guidelines underwent ultrasound-guided episcleral brachytherapy with a total prescribed dose of 72.40 Gy to the apex. Results: Among the included cases, 47.7 and 44.3% had a clinical tumour stage of T2 and T3, respectively. With a median follow-up of 84 (range 7–153) months, local control at 5 and 10 years was 100 and 95%, respectively. Among the 88 patients, 9 (10.2%) were enucleated after brachytherapy. Those with T1–T2 and T3–T4 disease had a 10-year CSS of 100 and 87.3%, respectively (p = 0.017). MFS at 5 and 10 years was 100% in those with T1–T2 disease and 92.1 and 83.1% in those with T3–T4, respectively (p = 0.016). Five patients had liver metastases, all of whom had T3–T4 disease. Conclusion: Ultrasound-guided episcleral brachytherapy with 125-I seeds yielded excellent local control for choroidal melanoma, with low complication rates and 90% eye preservation. Given the association between tumour stage and liver metastases, which remain the main cause of death, stricter control should be employed for T3–T4 tumours for the early detection and treatment of relapses.
Ocul Oncol Pathol

中文翻译：

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超声引导下巩膜外近距离放射治疗脉络膜黑色素瘤：长期结果和转移风险

简介：本研究的目的是阐明接受 125-I 粒子进行巩膜外近距离放射治疗的脉络膜黑色素瘤患者的长期结果；分析病因特异性生存 (CSS)、无转移生存 (MFS) 和局部控制；并建立肿瘤大小和转移之间的关系。方法：从 2007 年 5 月至 2013 年 2 月，根据美国癌症联合委员会指南分类的 88 名患者接受了超声引导下的巩膜外近距离放射治疗，顶点的总处方剂量为 72.40 Gy。结果：在纳入的病例中，47.7%和44.3%的临床肿瘤分期分别为T2和T3。中位随访时间为 84（范围 7-153）个月，5 年和 10 年的局部控制率分别为 100% 和 95%。在 88 名患者中，9 名（10.2%）在近距离放射治疗后被摘除。T1-T2 和 T3-T4 疾病患者的 10 年 CSS 分别为 100% 和 87.3%（p = 0.017）。T1-T2 患者 5 年和 10 年的 MFS 分别为 100%，T3-T4 患者分别为 92.1% 和 83.1%（p = 0.016）。5 名患者有肝转移，所有患者均患有 T3-T4 疾病。结论：使用 125-I 粒子进行的超声引导下巩膜外近距离放射治疗对脉络膜黑色素瘤产生了极好的局部控制，并发症发生率低，眼睛保留率为 90%。鉴于肿瘤分期和肝转移之间的关联，肝转移仍然是死亡的主要原因，因此应对 T3-T4 肿瘤进行更严格的控制，以早期发现和治疗复发。
眼肿瘤病理