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脉络膜黑色素瘤与妊娠

Lematre S, Lévy-Gabriel C, Desjardins L, et al.

期刊名称:Acta Ophthalmologica

卷期:2016年第94卷第7期

摘要

目的:脉络膜黑色素瘤是一种成人罕见的肿瘤。诊断时平均年龄60岁,但这种肿瘤可影响育龄妇女。迄今为止,尚未正式排除怀妊娠对患者生存的负面影响。本研究旨在评估妊娠对脉络膜黑色素瘤预后的影响。方法:我们在Curie研究所进行了一项单中心回顾性研究,对19806月份至201310月之间诊断为脉络膜黑色素瘤的育龄妇女进行了研究。我们对诊断时怀孕以及治疗后选择怀孕者的预后特别感兴趣。结果:我们发现了27例诊断时怀孕的患者和治疗后怀孕的患者。这两组患者和其他诊断为脉络膜黑色素瘤的育龄妇女的生存率没有差异(p = 0.52)。无转移存活也没有差异(p = 0.91)。大多数妇女能够足月妊娠(67%足月,只有7%流产)。对于怀孕时确诊患有脉络膜黑色素瘤的女性,85%的病例选择保守治疗,质子束治疗是最广泛使用的治疗。结论:育龄妇女的存活似乎不受妊娠的影响。我们发现,质子束治疗可用于治疗脉络膜黑色素瘤诊断时怀孕的妇女。

PURPOSE:Choroidal melanoma is a rare tumour in adults. The mean age at diagnosis is 60, but the tumour can affect women of childbearing age. A negative effect of pregnancy on patients' survival has not been formally excluded to date. The aim of the present study is to evaluate the effect of pregnancy on the prognosis of choroidal melanoma.METHODS:We conducted a single-centre retrospective study at the Institut Curie on the population of women of childbearing age who were diagnosed with choroidal melanoma between June 1980 and October 2013. We took a particular interest in the prognosis of those who were pregnant at the time of diagnosis and in the prognosis of those who chose to get pregnant after the treatment.RESULTS:We found 27 pregnant patients at the time of diagnosis and 13 patients who became pregnant after the treatment. There was no difference in the survival between these two groups of patients and the group of other women of childbearing age diagnosed with choroidal melanoma (p=0.52). There was also no difference in metastasis-free survival (p=0.91). Most women were able to carry their pregnancies to term (67% had a term pregnancy, and only 7% had an abortion). For women who were pregnant when they were diagnosed with choroidal melanoma, a conservative treatment was chosen in 85% of cases, and proton beam therapy was the most widely used treatment.CONCLUSIONS:Survival in women of childbearing age does not appear to be influenced by pregnancy. We show that proton beam therapy can be used to treat women who are pregnant at the time of choroidal melanoma diagnosis.


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