目的探讨难治性脉络膜血管瘤放疗的最佳介入时机及其与疗效的关系。方法回顾分析2005-2016年经复旦大学附属眼耳鼻喉科医院眼科确诊后转至放疗科的23例(23只患眼)难治性脉络膜血管瘤患者资料。放疗总剂量24 Gy(3 Gy8次)14只眼,34 Gy (2 Gy17次)5只眼,46 Gy (2 Gy23次)4只眼。根据放疗总剂量的高低、放疗前是否接受过其它治疗、患眼首次出现自觉症状至接受放疗的时间是否超过1年进行分组,采用Fisher's精确概率法比较组间疗效差异。结果放疗6个月后70%(16/23)患眼达有效。患眼自出现自觉症状至接受放疗不超过1年组的治疗有效率高于放疗超过1年组(P<0.05);放疗前积极治疗组和保守治疗组间疗效相近(P >0.05),低剂量组和高剂量组间疗效也相近(P >0.05)。结论 应用放疗治疗难治性脉络膜血管瘤是安全有效的,而且尽早接受放疗有助于患眼的视力恢复。
Objective To investigate the relationship between the timing and the curative effect of radiotherapy in the treatment of refractory choroidal hemangioma. Methods Clinical data of 23 patients (23 eyes) who were diagnosed with refractory choroidal hemangioma from August 2005 to August 2016 and treated in our hospital were retrospectively analyzed. Routine fractional radiotherapy was performed. The total dose of routine radiotherapy was 24 Gy (3 Gy/8F) for 14 eyes,34 Gy (2 Gy/17F) for five eyes and 46 Gy (2 Gy/23F) for four eyes,respectively. Patients were divided into the low-and high-dose groups,early-and late-radiotherapy groups,and active-and expectant-treatment groups according to the total dose of radiotherapy,whether they received active-or expectant-treatment before radiotherapy,and whether the time interval between the incidence of initial symptoms and the time of receiving radiotherapy exceeded one year. The curative effect between two groups was statistically compared by Fisher's exact test. Results A total of 70%(16/23) of the affected eyes were cured at 6 months after radiotherapy. The effective rate in the diseased eyes receiving radiotherapy within 1 year after the onset of initial symptoms was significantly higher than that in those receiving radiotherapy over 1 year (P<0.05),whereas no statistical significance was observed in the effective rate between the low-and high-dose groups,and between the active-and expectant-treatment groups (both P >0.05). Conclusions Radiatherapy is a safe and effective treatment of refratory choroidal hemangioma. Early radiotherapy contributes to the recovery of visual acuity of the affected eyes.
Chinese Journal of Radiation Oncology