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VOLUME 96 , ISSUE 5S ( September-October, 2022 ) > List of Articles

ARTÍCULO ORIGINAL

Sistema de radiocirugía robótica estereotáctica CyberKnife en estadios avanzados de melanoma uveal ciliocoroideo. Resultados preliminares en México

Gustavo Ortiz-Morales, Irving Dominguez-Varela, Daniela E. Gomez-Elizondo, Erik Perez-Ramos, Sara González-Godínez, Dione Aguilar-y-Méndez, Christian Estrada-Hernández, Ramiro Corral, Octavio Zamorano-Gómez, Carol L. Shields, Lauren A. Dalvin, Efren Gonzalez-Monroy, David Ancona-Lezama

Keywords : CyberKnife, Melanoma uveal, Radiocirugía estereotáctica, Abordaje multidisciplinario, Oncología ocular

Citation Information : Ortiz-Morales G, Dominguez-Varela I, Gomez-Elizondo DE, Perez-Ramos E, González-Godínez S, Aguilar-y-Méndez D, Estrada-Hernández C, Corral R, Zamorano-Gómez O, Shields CL, Dalvin LA, Gonzalez-Monroy E, Ancona-Lezama D. Sistema de radiocirugía robótica estereotáctica CyberKnife en estadios avanzados de melanoma uveal ciliocoroideo. Resultados preliminares en México. 2022; 96 (5S):205-212.

DOI: 10.24875/RMO.M22000236

License: CC BY-NC-ND 4.0

Published Online: 07-11-2022

Copyright Statement:  Copyright © 2022 Sociedad Mexicana de Oftalmología. Publicado por Permanyer.


Abstract

Objetivo: Reportar los resultados iniciales de la cirugía estereotáctica con CyberKnife® (CK®) para etapas avanzadas de melanoma de cuerpo ciliar y coroides (MCC-C) en pacientes mexicanos. Método: Revisión retrospectiva de expedientes clínicos. Se analizaron los resultados de los pacientes a quienes se trató con CK® (Accuray Inc, Sunnyvale, CA, Estados Unidos). Resultados: Cuatro pacientes con MCC-C fueron tratados bajo este protocolo. La media de edad fue de 53.2 ± 5.3 años (rango: 47-60). La mediana de seguimiento fue de 9.5 ± 3.1 meses (rango: 5-12). El diámetro promedio del tumor fue de 13.49 mm, el grosor promedio fue de 11.74 mm y el volumen tumoral promedio fue de 1251.97 mm3. Los tumores tuvieron una configuración de domo (50%) y de seta (50%), de tamaño mediano a grande. Tres pacientes tuvieron un tumor T3b y uno tuvo un tumor T4d en fase inicial según el American Joint Committee on Cancer (AJCC). Se prescribió una dosis promedio de radiación de 2763 ± 181,3 cGy al 90% de la línea de isodosis. Todos los pacientes lograron el control local del tumor después de una sesión de radiocirugía en la última visita de seguimiento. Un paciente presentó datos de toxicidad aguda (desprendimiento seroso de retina) y fue tratado con éxito. Ninguno de los pacientes precisó enucleación secundaria. Conclusiones: El abordaje multidisciplinario con CK® es una terapia efectiva en el manejo del MCC-C de tamaño mediano a grande. Es necesario mayor tiempo de seguimiento para confirmar estos hallazgos y evaluar la morbilidad a largo plazo.

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