Side Effects of Proton Beam Radiotherapy Treatment on Iris Melanoma

Ophthalmology Volume 130, Number 9, September 2023

質子束放射線治療對虹膜黑色素瘤的副作用

中文摘要

該研究評估了質子束放射線治療（Proton Beam Radiotherapy, PBR）在處理虹膜黑色素瘤（Iris melanoma, IM）中的功能結果和副作用。該研究通過回顧性檢閱從2011年1月到2020年12月收集的數據進行。研究考慮了兩種類型的PBR：整個前部段PBR（whole anterior segment PBR, wPBR）和分段前部段PBR（segmenetal anterior segment PBR, sPBR）。

該研究發現PBR是治療IM的高度有效方法，並且具有很低的復發率。然而，這兩種PBR的副作用是有差異的。兩個組別中最常見的副作用是乾眼症。嚴重的副作用，如輪狀幹細胞功能衰竭和角膜病變，僅在wPBR組中發現。次發性青光眼在wPBR組中也更常見，兩個組別中都觀察到了白內障的發展，但在wPBR組中更為明顯。

該研究的結論是，PBR是處理IM的成功治療選項，但建議sPBR作為首選治療，因為其嚴重副作用較少。需要進一步的研究來了解這些治療的長期影響。

English Abstract

The study evaluates the functional outcomes and side effects of Proton Beam Radiotherapy (PBR) in treating Iris Melanoma (IM). The research was conducted as a retrospective review of data collected from January 2011 to December 2020. Two types of PBR were considered: Whole Anterior Segment PBR (wPBR) and Segmental Anterior Segment PBR (sPBR). Side effects were divided into ocular surface disease (OSD), secondary glaucoma,or cataract development.

The study found that PBR is a highly effective treatment for IM with a low recurrence rate (3patients: wPBR:1/51; sPBR:2/98). However, the side effects varied between the two types of PBR. The most common side effect in both groups was dry eye syndrome. Severe side effects like limbal stem cell failure and keratopathy were only found in the wPBR group. Secondary glaucoma was also more common in the wPBR group, and cataract development was observed in both groups but was higher in the wPBR group.

The study concludes that PBR is a successful treatment option for IM but recommends sPBR as the first treatment choice due to fewer severe side effects. Treatment with wPBR should be limited to cases with 360-degree angle involvement or diffuse iris surface seeding where sPBR would be insufficient. Further research is needed to understand the long-term impact of these treatments.