NR 3-4/2003
|
|
|
|
|
|
|
|
|
Leczenie wewnątrzgałkowych guzów
przerzutowych
Treatment of intraocular metastatic tumors
Bożena Romanowska-Dixon
Z Katedry i Kliniki Okulistyki Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie
Kierownik: prof. dr hab. n. med. Maria Starzycka |
|
|
| Summary: |
Purpose: Analysis of the clinical picture
of intraocular metastatic tumors and the results of the treatment with various methods.
Material and methods: Between 1994-1997 intraocular metastatic tumors
were diagnosed in 14 patients (19 eyes). There were 13 females and 1 male, aged 28 to 69
years (average 50). The primary tumor in 8 patients developed in the breast, in 4 cases in
the lungs, 1 in the brain, and 1 in the kidney. In all patients the primary tumor was
excised, then chemotherapy was applied in 9 cases, radiotherapy in 3 cases, and hormonal
treatment in 2 cases. In 7 patients the metastatic process concerned also other organs:
bones, liver, lungs, hypophysis, and lymphatic glands. Metastases developed in 10 months
to 11 years since the diagnosis and treatment of the primary tumor.
Intraocular tumors were the most often located near the optic disc (8 cases), or near the
macula (4 cases). There were usually flat tumors (in 12 cases < 5 mm in thickness),
creamy white, sometimes with pigment clamping. In order, to confirm the diagnosis of the
tumor, USG was always performed and in 8 cases fluorescein angiography.
In all cases topical treatment was applied, which consisted of irradiation with ruthenium
(106Ru) in 6 eyes (in 1 case two times), laser coagulation in 3 eyes, and thermotherapy
(TTT) with diode laser in 4 eyes, combined treatment (106Ru +TTT) in 2 eyes, 106Ru and
125I brachytherapy in one eye. The dose of radiation for the apex of the tumor was 60-90Gy
(av. 65). The eyeball was enucleated in 3 patients, 4 patients received chemotherapy. 2
patients received hormonal therapy, applied together with the topical treatment.
Results: In the majority of cases (14 eyes), a flat scar or the
significant decrease of the volume of the tumor was obtained. 8 patients died, two are
currently observed, the remaining 4 do not come to the control examination, and there is
no information as to their fate.
Conclusions: Good results of the treatment encourage further application
of brachy and thermotherapy in the treatment of intraocular metastatic tumors. It allows
for the conservative treatment of the eyeball, and also useful visual acuity is retained
often. |
| Słowa kluczowe: |
wewnątrzgałkowe przerzuty nowotworowe, brachyterapia,
przezźreniczna termoterapia. |
| Key words: |
intraocular metastatic tumors, brachytherapy, transpupillary
thermoterapy |
|
|
|
|
|
|
