Clinical Features and Treatment Outcomes in Patients with Choroidal Metastases

Full Article

PK Yip, CCY Wong, FMY Lim, RKY Wong

Hong Kong J Radiol 2019;22:49-55

https://doi.org/10.12809/hkjr1916835

Introduction: Choroidal metastasis is the most common intraocular malignancy, which causes visual loss and hence adversely affects patient’s quality of life. External beam radiotherapy (RT) remains the treatment of choice. This retrospective study aimed to look at the treatment outcomes and clinical features in patients with choroidal metastases.
Methods: It is a retrospective single-centre study. Patients with choroidal metastases diagnosed between 2006 and 2016 were identified from RT treatment database. Treatment outcomes after RT in terms of visual and objective response, median time to response were analysed. Clinical features regarding patients’ demographics, cancer and ocular disease characteristics and survival were evaluated.
Results: 21 patients with 28 involved eyes were identified. The median age at diagnosis of choroidal metastases was 55 years. The female-to-male ratio was 4:3. Bilateral choroidal metastases were found in seven (33%) patients. Concurrent or subsequent brain metastases were developed in eight (38%) patients. The most common symptom was blurring of vision (95%). The most common primary tumour type was lung carcinoma (n=9, 43%). The median survival was 5 months. The median prescribed biological effective dose was 39 Gy₁₀ (range, 28-39 Gy₁₀). Visual improvement was observed in 70% of irradiated eyes. Median time to visual improvement was 3.5 months (range, 2-5 months). Complete and partial remissions were achieved in nine (70%) eyes and two (15%) eyes, respectively.
Conclusion: RT can effectively improve vision of patients with choroidal metastases. Prognosis in this group of patient remains poor.

Author affiliation(s):
PK Yip, FMY Lim, RKY Wong: Department of Oncology, Princess Margaret Hospital, Laichikok, Hong Kong
CCY Wong: Department of Ophthalmology, Caritas Medical Centre, Shamshuipo, Hong Kong

中文摘要

眼脈絡膜轉移患者的臨床特徵和治療效果

葉佩潔、黃鉦沅、林美瑩、黃家仁

引言： 眼脈絡膜轉移是最常見的眼內惡性腫瘤，可導致視力喪失並對患者的生活質素產生不良影響。體外放射放療是首選治療方法。這項回顧性研究旨在研究眼脈絡膜轉移患者的治療結果和臨床特徵。
方法： 這項回顧性單一中心研究，從放射治療數據庫識別2006 年至2016 年間診斷為眼脈絡膜轉移的患者，分析放射治療的療效，包括視覺改善和腫瘤客觀治療反應的中位數，以及評估患者的人口統計學、癌症和視覺病患臨床特徵和存活期。
結果： 在數據庫識別出21 名患有眼脈絡膜轉移的患者，涉及28 隻眼睛。患病年齡中位數為55 歲。女性與男性的比例為4 ：3 。在7 名（33% ）患者中發現雙側脈絡膜轉移。8 名（38% ）患者同時或隨後出現腦轉移。最常見的症狀是視力模糊（95% ）。最常見的原發性腫瘤類型是肺癌（n=9 ，43% ）。存活期中位數為5 個月。患者接受的生物有效劑量中位數為39 Gy₁₀ （介乎28-39 Gy₁₀ ）。有70% 的眼睛在接受放射治療後視覺有所改善。視力改善的中位時間為3.5 個月（介乎2-5 個月）。9 隻眼（70% ）和2 隻眼（15% ）分別達到完全和部分緩解。
結論： 放射治療可有效改善眼脈絡膜轉移患者的視力，惟這組患者的預後仍然不理想。