Retrospective multicenter study on results of gamma knife surgery for uveal melanoma in Europeстатья Тезисы

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Дата последнего поиска статьи во внешних источниках: 29 марта 2018 г.

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[1] Retrospective multicenter study on results of gamma knife surgery for uveal melanoma in europe / C. Mikhail, S. Fery, M. Gabriela et al. // JOURNAL OF RADIOSURGERY AND SBRT. — 2017. — Vol. 5, no. s1. — P. 65–66. The objective of the present study was retrospective evaluation of results of Gamma Knife surgery (GKS) for uveal melanoma performed in 8 European Gamma Knife centers (Bucharest, Florence, Istanbul, Moscow, Prague, Saint Petersburg, Sheffield, and Zurich), which agreed to participate and provided required information. Study design presumed collection of the various data (62 investigated variables) on individual patients with creation of the integrated database for further statistical analysis. Primary end-points were overall survival, local tumor control, eye retention rate, and morbidity during follow-up. Secondary end-points were tumor response, preservation of visual function on the affected eye, and incidence of metastatic disease after GKS. In total 349 cases were collected. All patients were treated between July 2001 and October 2015. The stage of treated tumors corresponded to I, IIA, IIB, and IIIA in 26%, 43%, 23% and 7% of cases, respectively. Eye fixation was attained with retrobulbar anesthetic blocking in 65% of cases or suturing of rectus muscles in 24% of cases; in dose was 30 Gy (range, 25-30 Gy), median maximal dose was 50 Gy (range, 30-80 Gy), median maximal dose to the ipsilateral optic nerve was 8.7 Gy (range, 0.7 – 61.2 Gy). In 23 patients GKS was done before planned eye-preserving endoresection of the tumor. Follow-up information was available in 314 cases and median length of follow-up was 40 months (range, 1-132 months). Actuarial survival rates at 3 and 5 years after GKS were 91% and 89%, respectively. Crude tumor control rate was 98%. Complete response was noted in 19% of cases, partial response in 46% of cases. Crude eye-retention rate was 95.5%. In overall 13 enucleations were done owed to tumor progression (5 cases), complications (2 cases), or unknown reasons (6 cases). Complications were noted in 67% of patients, and exudative retinal detachment (15%), cataract (13%), neovascular glaucoma (11%) and retinopathy (11%) were the most common. The risk of loss of the useful vision on the affected eye during follow-up after GKS was 40%. Suturing of the extraocular muscles for eye fixation during irradiation and two-staged treatment (GKS followed by planned endoresection of the tumor) were associated with significantly lower risk of complications and visual loss on the affected eye. Distant metastases after treatment were disclosed in 10% of patients. In conclusion, GKS seems effective treatment option for management of uveal melanoma at early stage of disease.

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