A 17-year retrospective study of institutional results for eye plaque brachytherapy of uveal melanoma using 125I, 103Pd, and 131Cs and historical perspective
“…Fourteen studies were retrospective clinical chart reviews [14,15,22,23,24,25,26,27,28,29,30,31,32], and 1 was a prospective, randomized trial, the COMS trial [17]. One retrospective study included patients from the COMS trial [15].…”
Aim: To investigate whether lower radiation doses may yield similar outcome measures to those from the COMS trial. Methods: A literature review of English language articles was performed using the PubMed database of the U.S. National Library of Medicine and the Cochrane Central Register of Controlled Trials using the following keywords: uveal melanoma, choroidal melanoma, primary uveal malignant melanoma, iodine-125 brachytherapy, local recurrence, local treatment failure, and local tumor control. The relationships between study local recurrence rate and median dosage were tested by linear regression, with each study weighted by the number of patients included. Results: Fifteen retrospective and prospective studies were selected for systematic review (2,662 patients). Ranges of reported mean or median radiation dose to tumor apex were 62.5-104.0 Gy. Local recurrence rates ranged from 0 to 24%. A 1.0-Gy increase in the average study dose was associated with a 0.14% decrease in local recurrence rate, which was not statistically significant (p value 0.336). Conclusion: The gold standard empirically derived 85.0-Gy radiation dose for the treatment of uveal melanoma could be tested in a randomized study.
“…Fourteen studies were retrospective clinical chart reviews [14,15,22,23,24,25,26,27,28,29,30,31,32], and 1 was a prospective, randomized trial, the COMS trial [17]. One retrospective study included patients from the COMS trial [15].…”
Aim: To investigate whether lower radiation doses may yield similar outcome measures to those from the COMS trial. Methods: A literature review of English language articles was performed using the PubMed database of the U.S. National Library of Medicine and the Cochrane Central Register of Controlled Trials using the following keywords: uveal melanoma, choroidal melanoma, primary uveal malignant melanoma, iodine-125 brachytherapy, local recurrence, local treatment failure, and local tumor control. The relationships between study local recurrence rate and median dosage were tested by linear regression, with each study weighted by the number of patients included. Results: Fifteen retrospective and prospective studies were selected for systematic review (2,662 patients). Ranges of reported mean or median radiation dose to tumor apex were 62.5-104.0 Gy. Local recurrence rates ranged from 0 to 24%. A 1.0-Gy increase in the average study dose was associated with a 0.14% decrease in local recurrence rate, which was not statistically significant (p value 0.336). Conclusion: The gold standard empirically derived 85.0-Gy radiation dose for the treatment of uveal melanoma could be tested in a randomized study.
“…Dose rate inside the eye, however, may be estimated with comparable accuracy. Moreover, the EP method overcomes three significant limitations of the Tufts, Dome, or Plaque Simulator methods: Dose rate calculations may be performed (1) using FDA-approved TPSs, including Varian Brachytherapy TPS; (2) for EPs loaded with sources other than 125 I Model 6711 and 103 Pd Model 200; and (3) for seed configurations different than standard COMS.…”
Section: Introductionmentioning
confidence: 99%
“…Brachytherapy treatment of ocular malignancies, including but not limited to uveal melanoma, is most commonly performed in North America with Collaborative Ocular Melanoma Study (COMS) eye plaques (EPs) (1). The COMS EPs are available in standard designs and sizes to accommodate a range of tumor dimensions (2).…”
“…4 A variety of low-energy photon-emitting radionuclides have been used but with no apparent differences in clinical outcomes. 1,2,[5][6][7] Dale quantitatively evaluated the biologically effective dose (BED) of nonpermanent brachytherapy implants as a function of several parameters. 8 In the present study, a method was developed to assess the volumetric dependence of BED as a function of implant duration, radionuclide, and radiobiological parameters for the tumor and organs at risk (OARs).…”
BEDVH permits evaluation of the relative biological effectiveness for brachytherapy implants. For eye plaques, (TUMOR)BEDVH and (OAR)BEDVH were sensitive to implant duration, which may be manipulated to affect outcomes.
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