15-year experience of using transpupillary thermotherapy according to the developed method in the treatment of choroidal melanomas of small-size Т1 stage
melanomas (CM) of small size (protrusion to 3.5-4 mm, according to the
literature data), that are the initial stage of the disease, require a special
approach in determining of management.
of the Department of Ophthalmo oncology of the SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine " developed a diode-laser (810 nm) transpupillary thermotherapy (TTT) technique, which has been used for more than 15 years. TTT (810 nm) is carried out on the ophthalmocoagulator "Iridis Quantel medical" (France) in continuous-wave mode of impact with gradual increase of power from 200 mW to 1800 mW (individual selection). The diameter of the laser spot ranged from 1.25 to 4.0 mm, exposure dose of influence-1 minute, the number of applications depends on the size of the tumor length. Repeated exposure courses are conducted if necessary with intervals of 2.5-3 months during the year.
The result of 15 years usage of TTT was studied in patients with CM of small size Т1 stage (protrusion to 3 mm and length of subiculum to 12 mm). The local treatment result was evaluated as positive (total or partial tumor cicatrization) or negative (no effect or continued tumor growth). Distant treatment results were assessed by patient survival and development of metastatic disease.
At the time of the beginning of treatment, no patients had been identified with metastases.
Follow-up period for patients was between 12 and 180 months. It is noted that
1) The developed method of TTT of choroidal melanomas of small size Т1 stage (protrusion to 3 mm and length of subiculum to 12 mm) allows to obtain local positive result of treatment in 92.05% of cases.
2) The CM protrusion of more than 2 mm is prognostically less favorable for obtaining positive local treatment result (test sensitivity - 88.2%, specificity - 82.4%; р =0,0001).
person: S.I. Poliakova, Doctor of Medicine