CAJ | 학술논문

目的观察放射疗法(放疗)对难治性脉络膜血管瘤的临床效果.方法回顾性研究.经氩激光光凝或光动力疗法多次治疗无效的脉络膜血管瘤患者8例8只眼纳入研究.其中,男性7例,女性1例;年龄11～54岁,平均年龄(27.50±15.18)岁.均为单眼发病,右眼3只,左眼5只.孤立性脉络膜血管瘤5只眼,弥漫性脉络膜血管瘤3只眼.均合并广泛渗出性视网膜脱离.患眼视力为光感～0.01.肿瘤体积1.96～5.35 cm3,肿瘤平均体积(3.37±1.06) cm3.所有患者采用X射线行常规分次放疗.4例患者放疗总剂量24 Gy,3 Gy/次,共8次;另4例患者放疗总剂量46 Gy,2 Gy/次,共23次.治疗后随访7～95个月,随访时间中位数42个月.结果所有患眼渗出性视网膜脱离复位,渗液吸收,且均未发生再次视网膜脱离.末次随访时,患眼视力为光感～0.6.8只眼中,视力提高6只眼,无变化2只眼.肿瘤体积1.24～2.16 cm3,肿瘤平均体积(1.68±0.30) cm3.与治疗前比较,治疗后肿瘤体积缩小14.6％～72.7％,平均缩小(44.89±21.30)％.所有患眼均未出现与放疗相关的角膜、晶状体、视网膜病变或视神经病变等并发症.结论放疗可安全、有效地治疗难治性脉络膜血管瘤.
목적 관찰방사요법(방료)대난치성맥락막혈관류적림상효과.방법 회고성연구.경아격광광응혹광동력요법다차치료무효적맥락막혈관류환자8례8지안납입연구.기중,남성7례,녀성1례;년령11～54세,평균년령(27.50±15.18)세.균위단안발병,우안3지,좌안5지.고립성맥락막혈관류5지안,미만성맥락막혈관류3지안.균합병엄범삼출성시망막탈리.환안시력위광감～0.01.종류체적1.96～5.35 cm3,종류평균체적(3.37±1.06) cm3.소유환자채용X사선행상규분차방료.4례환자방료총제량24 Gy,3 Gy/차,공8차;령4례환자방료총제량46 Gy,2 Gy/차,공23차.치료후수방7～95개월,수방시간중위수42개월.결과 소유환안삼출성시망막탈리복위,삼액흡수,차균미발생재차시망막탈리.말차수방시,환안시력위광감～0.6.8지안중,시력제고6지안,무변화2지안.종류체적1.24～2.16 cm3,종류평균체적(1.68±0.30) cm3.여치료전비교,치료후종류체적축소14.6％～72.7％,평균축소(44.89±21.30)％.소유환안균미출현여방료상관적각막、정상체、시망막병변혹시신경병변등병발증.결론 방료가안전、유효지치료난치성맥락막혈관류.
Objective To observe the effectiveness of radiotherapy for refractory choroidal hemangioma.Methods Eight patients (8 eyes) with choroidal hemangioma were enrolled in this retrospective study.All the patients had received laser or photodynamic therapy before without effectiveness.The patients included 7 males and 1 females.The age was ranged from 11 to 54 years old,with an average of (27.50± 15.18) years.All the patients were affected unilaterally,including 3 right eyes and 5 left eyes.There were 5 eyes with circumscribed choroidal hemangioma,3 eyes with diffused choroidal hemangioma.All eyes had extensively exudative retinal detachment.The vision was from light sensation to 0.01.The volume of the tumors was ranged from 1.96 to 5.35 cm3,with a mean of (3.37±1.06) cm3.All the patients were treated with X rays by conventional fractional radiotherapy.Four of 8 patients were applied 24Gy totally in 8 fractions,while the other 4 patients were applied 46Gy in 23 fractions.Follow-up period ranged from 7 to 95 months,with medium of 42 months.Results Retinas reattached in all the eyes while exudation being absorbed.No retinal detachment happened again.To the last follow-up,the vision was from light sensation to 0.6.Visual activity improved in 6 eyes while 2 eyes improved obviously.Visual acuity was stable in remaining 2 eyes.The volume of the tumors decreased to 1.24-2.16 cm3,with a mean of (1.68±0.30) cm3.The percentage of the tumor decreased by 14.6-72.7,with an average of (44.89±21.30) ％.No radiotherapy-associated complication occurred.Conclusion Radiotherapy is an efficient and safe treatment for refractory choroidal hemangioma.