Introduction
A retrospective evaluation of effectiveness of brachytherapy or enucleation in treatment of rare form of uveal melanoma: ring melanoma.

Material and methods
Analysis comprised 49 patients treated from 2000 to 2019 for ring melanoma involving ciliary body. In 15 patients, primary treatment consisted of brachytherapy (106Ru or 125I), whereas in 34 patients, eyeballs were enucleated. The evaluation concerned differences between analyzed groups relating to the clinical and histopathological features as well as overall survival, cancer-specific overall survival, and disease-free survival.

Results
No significant differences between the analyzed groups were found with regards to clinical and histopathological features, apart from intra-ocular pressure (increased in the enucleation group). Kaplan-Meier analysis did not reveal any significant differences between the group treated with enucleation and the group undergoing brachytherapy, both with regards to overall survival (p = 0.325) and cancer-specific overall survival (p = 0.477). A significant difference was observed in disease-free survival (p = 0.009), which was significantly shorter in the group undergoing brachytherapy. In the analysis of parameters of the applied brachytherapy, no significant differences between patients with and without local recurrence were found. Mean observation period was 350.8 weeks (range, 24-996 weeks, SD = 231.6). A local recurrence occurred in 11 (22.4%) patients, including 3 (6.1%) in enucleation and 8 (16.3%) after brachytherapy groups. Metastasis developed in 11 (22.4%) cases after a mean follow-up of 133 weeks (33.25 months), range 3-655 weeks.

Conclusions
Preliminary observations may suggest that brachytherapy in this rare form of uveal melanoma, such as ring melanoma involving the ciliary body, may be taken into consideration as a useful alternative to enucleation. However, the confirmation of such an approach requires a larger patients’ group to be gathered, and also a longer follow-up period. This is especially important in patients with a good baseline visual acuity in the affected eye, or when the neoplasm is present in the remaining eye with vision.



中文翻译：

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环形黑色素瘤患者的近距离放射治疗或摘除：哪个更好？作者亲身经历的初步结果

简介
回顾性评估近距离放射治疗或摘除治疗罕见葡萄膜黑色素瘤的有效性：环状黑色素瘤。

材料和方法
分析包括从 2000 年到 2019 年因涉及睫状体的环状黑色素瘤接受治疗的 49 名患者。在 15 名患者中，主要治疗包括近距离放射治疗（106Ru 或 125I），而在 34 名患者中，眼球被摘除。评估涉及与临床和组织病理学特征以及总生存期、癌症特异性总生存期和无病生存期相关的分析组之间的差异。

结果
除了眼压（在摘除组中增加）外，在临床和组织病理学特征方面，分析组之间没有发现显着差异。Kaplan-Meier 分析未显示在总生存期 (p = 0.325) 和癌症特异性总生存期 (p = 0.477) 方面，去核治疗组和近距离放射治疗组之间存在任何显着差异。无病生存期有显着差异（p = 0.009），在接受近距离放射治疗的组中，无病生存期显着缩短。在应用近距离放射治疗的参数分析中，发现有和没有局部复发的患者之间没有显着差异。平均观察期为 350.8 周（范围，24-996 周，SD = 231.6）。11例（22. 4%) 患者，包括 3 名 (6.1%) 摘除组和 8 名 (16.3%) 近距离放射治疗组。平均随访 133 周（33.25 个月）后，11 例（22.4%）病例发生转移，范围为 3-655 周。

结论
初步观察结果可能表明，对于这种罕见的葡萄膜黑色素瘤（例如涉及睫状体的环状黑色素瘤），近距离放射治疗可以作为摘除的有用替代方法。然而，这种方法的确认需要收集更大的患者群体，也需要更长的随访时间。这对于受影响眼睛具有良好基线视力的患者，或者当肿瘤存在于具有视力的剩余眼睛中时尤其重要。