Abstract
Abstract Photodynamic therapy in the combined treatment of choroidal melanoma E.V. Samkovich, I.E. Panova, E.V. Boyko, E.M. Svistunova, A.A. Bykhovskii S. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch, St. Petersburg North-Western State Medical University named after I.I. Mechnikov, St. Petersburg Purpose. To evaluate the effectiveness of the combined treatment ofchoroidal melanoma (CM) based on the use of PDT and Ru-106+Rh-106brachytherapy (BT). Material and methods. Retrospective analysiswas carried out in 48 patients (48 eyes) with CM. Distribution ofpatients according to TNM system: T1N0M0 – 2 patients, T2N0M0 – 14,T3N0M0 – 32. All patients were divided into 2 study groups: 1st group –25 patients (25 eyes) who underwent Ru/Ro-106 BT in isolation, SOD125.4±12.3 Gy; 2nd group – 23 patients (23 eyes) who underwentcombined treatment: Ru-106+Rh-106 BT (SOD 127.3±13.6 Gy) + PDT.Diagnostics was carried out on the basis of clinical and instrumentalexamination including complex ultrasound with estimation of thetumor vascularization degree. Results. Application of complex organpreservation treatment, including photodynamic therapy, followedby BT promotes acceleration of rates of tumor regression in 3, 6, 12 months (p<0.05). It was reliably found that the signs of intratumoralvascularization of CM (p<0.05) decrease after a combined treatment.A comparative analysis of the effectiveness of the two variants of organpreservation treatment of CM has shown a higher efficacy of PDT andBT, based on complete regression of the tumor and local control ina significantly larger number of patients (p<0.05). Conclusion. Theresults of application of PDT in the combined treatment of CM show theprospects of the method application to achieve a faster rate of tumorregression and a preventive measure of haematogenous metastasis dueto necrosis and blocking of vessels feeding the tumor. Key words: choroidal melanoma, photodynamic therapy, brachytherapy,uveal melanoma, ophthalmo-oncology, choroidal melanoma treatment
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