EFFICIENCY OF RADIOWAVE (3.8 MHZ) BLOCKADE OF MELANOMA OF CELIOCHORIOIDAL LOCALIZATION
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i3.11599Keywords:
uveal melanoma, treatment, brachytherapy, prognosisAbstract
The aim of the study – to determine the effectiveness of radiowave surgery in the treatment of patients with ciliary body and choroidal melanoma in combination with adjuvant β-therapy.
Material and Methods. Clinical analysis was performed in 48 patients with iridocylchochorioid melanoma. All patients underwent tumor-based brachytherapy (40.0±0.2) days before surgery. Strontium-yttrium (90Sr+90Y) applicators were used as ophthalmic applicators. A single dose was 40 Gy, the total absorbed dose was 400 Gy
Results. After brachytherapy, all patients underwent partial resorption of the tumor (50–60 % of the original size). Patients did not have severe post-radiation reactions after irradiation, but in 23 (47.9 %) the manifestations of initial and immature cataracts increased. Much less often there was turbidity of the vitreous – 5 cases or 10.4 %). When assessing the frequency of postoperative complications in the control group, it was found that the most common complications were hemophthalmos (5 cases or 25.0 %), retinal detachment (3 cases or 15.0 %), epiretinal fibrosis (1 case or 5.0 %). In the main group there were 2 cases of hemophthalmos (7.1 %).
After the intervention, there was a decrease in the incidence of secondary glaucoma, IOP decreased to (21.3±3.6) mm Hg.
When assessing the dynamics of visual acuity, it was found that by the end of the first year of observation of patients with visual acuity greater than 0.6 were 6 (21.4 %) in group I, and 5 (25.0 %) – in group II.
Conclusions. 1. At celiochorioidal localization it is expedient to use brachytherapy with use of beta-active isotopes before surgical intervention. 2. After celiochorioidectomy with the use of cutting surgical tools with preliminary brachytherapy the frequency of postoperative complications is 5.7 times higher in comparison with the use of a radio-wave knife. 3. The use of radiowave method reduces the risk of recurrence by an order of magnitude, while direct (visual functions, postoperative clinical course) and long-term results (visual functions, state of optical media, IOP, the likelihood of tumor recurrence) do not depend on the method of tissue dissection.
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