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Klin Monbl Augenheilkd 2008; 225(7): 649-652
DOI: 10.1055/s-2008-1027432
Klinische Studie

© Georg Thieme Verlag KG Stuttgart · New York

Rezidivhäufigkeit nach Exzision von Bindehautmelanomen und adjuvanter Strontium-90-Kontaktbestrahlung

Recurrence Rate Following Adjuvant Strontium-90 Brachytherapy after Excision of Conjunctival MelanomaL. Krause1 , C. Ritter1 , J. Wachtlin1 , K.-M Kreusel2 , S. Höcht3 , M. H. Foerster1 , N. E. Bechrakis1, 4
  • 1Augenklinik, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin
  • 2Augen-Zentrum, DRK Kliniken Berlin Westend
  • 3Klinik für Radioonkologie und Strahlentherapie, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin
  • 4Universitäts Augenklinik Innsbruck, Innsbruck
Further Information

Publication History

Eingegangen: 30.12.2007

Angenommen: 21.2.2008

Publication Date:
18 July 2008 (online)

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Zusammenfassung

Hintergrund: Aufgrund der hohen Rezidivrate nach Bindehautmelanomexzision wird eine adjuvante lokale Chemotherapie oder eine Bestrahlung empfohlen. Hierbei kommt u. a. die Strontium-90-Kontaktbestrahlung wegen der geringen Eindringtiefe der Strahlung infrage. Patienten und Methoden: 15 Patienten mit einem Bindehautmelanom erhielten nach Tumorexzision eine adjuvante Strontium-90-Kontaktbestrahlung. Diese erfolgte fraktioniert in neun Sitzungen à 6 Gy. Die durchschnittliche Nachbeobachtungszeit betrug 35 Monate (12 – 60 Monate). Ergebnisse: Bei 7 Patienten (46 %) zeigte sich im Beobachtungszeitraum kein Tumorrezidiv. Bei drei Patienten (20 %) kam es in den bestrahlten und benachbarten Arealen zu einem Rezidiv. Acht Patienten (53 %) wiesen neue Tumoren in nicht bestrahlten Bindehautarealen auf. Schlussfolgerungen: Durch eine adjuvante Strontium-90-Kontaktbestrahlung ist eine relativ sicher durchzuführende adjuvante Behandlung nach Exzision von Bindehautmelanomen. Häufige Nachkontrollen sind erforderlich, da sich weitere Tumoren in nicht bestrahlten Arealen ausbilden können, insbesondere beim Vorliegen einer Melanose.

Abstract

Background: Because of the high local recurrence rates after excision of conjunctival melanomas, adjuvant local chemotherapy or irradiation is recommended. Strontium-90 brachytherapy is one radiotherapeutic option due to its low penetration depth. Methods: 15 patients with conjunctival melanoma were treated with adjuvant strontium-90 brachytherapy after tumour excision. The treatment was fractionated into 9 irradiation sessions with 6 Gy each. The mean follow-up was 35 months (12 – 60 months). Results: Seven patients (46 %) had no recurrence during the follow-up. Three patients (20 %) had a recurrence in the treated or adjacent area. Eight patients (53 %) developed new tumours in non-treated areas. Conclusions: Strontium-90 brachytherapy is a useful adjuvant in the treatment of conjunctival melanomas. Regular ophthalmoscopic controls are necessary because of the high rate of new tumours in non-irradiated areas, especially in cases with primary acquired melanosis.

Schlüsselwörter

Bindehaut - okuläre Tumoren - Bindehautmelanom - Strontium-90 - Kontaktbestrahlung - Tumorexzision

Key words

conjunctiva - ocular tumours - conjunctival melanoma - strontium-90 - brachytherapy - tumour excision

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Dr. Lothar Krause

Augenklinik, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin

Hindenburgdamm 30

12200 Berlin

Phone: ++ 49/30/84 45 23 42

Fax: ++ 49/30/84 45 44 50

Email: lothar.krause@charite.de

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