脉络膜黑色素瘤的X-刀治疗

The X－knife treatment for choroidal melanoma

目的 探讨X－刀治疗脉络膜黑色素瘤的疗效及照射剂量。 方法 采用60％～80％等剂量曲线覆盖靶区，肿瘤边界最小剂量18．4～27Gy，平均37．9Gy。治疗脉络膜黑色素瘤9例。 结果 平均随访18．7个月。眼球保留率88．9％（89）。治疗后1年计算机体层摄影（CT）、磁共振成像（MRI）检查结果示：肿瘤消失1例，缩小4例，无变化3例，进展1例。肿瘤周边剂量≤20Gy组有效率为25％（14）比＞20Gy组的80％（45）低，但由于例数少而无统计学差异。 结论 X－刀是治疗脉络膜黑色素瘤一种有效的方法。

Objective To evaluate the effect of the X－knife on choroidal melanoma and dose of radiosurgery． Method 9 patients with choroidal melanoma were treated by X－knife． The edge isodose line range from 60％ to 80％． The mean minimum dose was 21．9Gy（range 18．4－27Gy） and the maximum dose was 37．9Gy （27．5－58Gy）． Result Median follow－up was 18．7 months． The rate of eye ball preservation was 88％． Follow－up imaging findings showed disappearance in 1 patient, decrease in size of tumour in 4 patients, no change in 3 patients and increase in 1 patient． The effective rate of the adge dose≤20Gy and ＞20Gy groups were 25％ （14） and 80％（45）, respectively． Conclusion The X－knife is effective method for choroidal melanoma．