Clinical outcomes of Modified Collaborative Ocular Melanoma Study IRIS plaques for treatment of iris, iridociliary, and ciliary body melanoma

Xu, Timothy T.; Pulido, José S.; Deufel, Christopher L.; Corbin, Kimberly S.; Petersen, Ivy A.; Dalvin, Lauren A

doi:10.1038/s41433-020-01295-y

Cited by 8 publications

(6 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 1 ] Our 8% recurrence rate is consistent with existing literature, with post-EPB recurrence reported in 0%–9% of iris melanoma cases. [ 1 9 ] Notably, the single instance of recurrence was a ring melanoma. Ring melanoma can be difficult to detect at initial diagnosis as there may be an area of focal thickening, and the remainder of the ciliary body appears normal; it is a known mechanism of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Anterior plaque brachytherapy placement for treatment of iris and iridociliary melanomas – Surgical procedure and institutional experience

Pike,

Engelhard,

Greig

et al. 2024

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

Surgical placement of eye plaque brachytherapy (EPB) is the standard of care for the treatment of uveal melanomas, including iris/iridociliary melanomas. However, unique challenges exist in anterior EPB placement. Here, we describe a surgical technique for anterior EPB placement when placement requires plaque positioning onto the cornea. Blunt conjunctival peritomy exposes the sclera overlying the tumor. A ”dummy” plaque is placed, with positioning confirmed by direct visualization. The amniotic membrane is draped across the cornea and anchored with the eyelet sutures, the plaque is placed overlying the membrane, the conjunctiva is closed over the plaque, and a temporary tarsorrhaphy is performed. One week later, the conjunctival incision is reopened for plaque/amniotic membrane removal. This technique was employed in the treatment of 12 iris/iridociliary melanomas at our institution, with no instances of corneal damage. In placing an anterior plaque, employing this technique allows appropriate cancer treatment while optimizing patient comfort and corneal integrity.

show abstract

Section: Discussionmentioning

confidence: 99%

Anterior plaque brachytherapy placement for treatment of iris and iridociliary melanomas – Surgical procedure and institutional experience

Pike,

Engelhard,

Greig

et al. 2024

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Patient-specific customization of radiotherapy may also be an avenue to mitigate vision-limiting radiation side effects. In plaque radiotherapy for the management of iris melanoma, custom-shaped plaques based on tumor extent have been used to decrease radiation to unaffected structures [33 ▪ ,34,35,36 ▪ ]. In a study of 22 patients with iris melanoma, Xu et al reported the use of segmental arcs of the dome-shaped traditional Collaborative Ocular Melanoma Study plaque to reduce radiation exposure outside the intended treatment area [33 ▪ ].…”

Section: Advances In Primary Uveal Melanoma Treatmentmentioning

confidence: 99%

“…In plaque radiotherapy for the management of iris melanoma, custom-shaped plaques based on tumor extent have been used to decrease radiation to unaffected structures [33 ▪ ,34,35,36 ▪ ]. In a study of 22 patients with iris melanoma, Xu et al reported the use of segmental arcs of the dome-shaped traditional Collaborative Ocular Melanoma Study plaque to reduce radiation exposure outside the intended treatment area [33 ▪ ]. At 51 months follow-up, the 3-year Kaplan–Meier risk of local tumor recurrence was 7%, with no patients developing systemic metastasis.…”

Section: Advances In Primary Uveal Melanoma Treatmentmentioning

confidence: 99%

“…At 51 months follow-up, the 3-year Kaplan–Meier risk of local tumor recurrence was 7%, with no patients developing systemic metastasis. Radiation side effects that could be adequately managed in follow-up included cataract (77%) and dry eye (23%), whereas vision-threatening complications such as neovascularization of the iris (5%) and neovascular glaucoma (5%) rarely occurred [33 ▪ ]. The body of literature regarding customized plaque radiotherapy and individualized planning for charged particle therapies continues to grow [34,35,36 ▪ ,37,38].…”

Section: Advances In Primary Uveal Melanoma Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Uveal melanoma: laboratory advances and new frontiers in patient care

Moser

Dalvin

2021

Current Opinion in Ophthalmology

Self Cite

View full text Add to dashboard Cite

Purpose of reviewTo review recent advancements in the genetic understanding, diagnosis, prognosis, and treatment of uveal melanoma (UM). Recent findingsUM is a molecularly distinct melanocytic malignancy driven by mutations in GNAQ or GNA11, with mitogen-activated protein kinase pathway upregulation. Earlier diagnosis and treatment are important factors for improving life prognosis. These goals can be aided by more objective multimodal imaging risk factors for the prediction of malignant nevus transformation and novel treatment strategies such as customized radiation fields and nanoparticle therapy to reduce vision-threatening treatment side effects. The risk for metastatic disease can be reliably predicted through gene expression profiling or the Cancer Genome Atlas project classification, and combined use of clinical tumor features with molecular data allows for highly individualized patient prognosis. Patients with high-risk UM should be considered for clinical trials of adjuvant therapy to prevent metastatic disease. For patients with clinically evident metastasis, combination immunotherapy regimens, T cell-based therapies, and focal adhesion kinase inhibitors offer hope for improved clinical response rates.

show abstract

“…Currently, brachytherapy, using isotopes of iodine-125 (I-125) and ruthenium-106 (Ru-106), is the most commonly used therapeutic approach for uveal melanoma, with a local control rate in the range of 88–98% at five years [ 1 ], and it is equivalent to enucleation in terms of prevention of systemic spread and death [ 2 ]. Consequently, plaque brachytherapy remains the method of choice to control primary intraocular tumors [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes after Surgical Resection Combined with Brachytherapy for Uveal Melanomas

Relimpio-López

Garrido-Hermosilla

Espejo

et al. 2022

JCM

View full text Add to dashboard Cite

Currently, brachytherapy is the most commonly used therapeutic approach for uveal melanomas. Surgical resection by means of endoresection or exoresection is an alternative approach. The present report recounts our experience over 15 years in the treatment of uveal melanoma using a combined approach of resection surgery with brachytherapy. This is a single-center observational retrospective cohort study in which we describe clinical outcomes, complications and survival in 35 cases of melanoma of the iris or the ciliary body after a combination of surgery and brachytherapy or brachytherapy alone. Local treatment of the tumor was successful in all cases with surgery and brachytherapy. The most frequent complications were scleromalacia, bullous keratopathy, retinal toxicity, cataracts, hypotonia, and photophobia. There were three cases of recurrence, all of which were found in the group of patients who had received brachytherapy alone, and in one case we had to perform a secondary enucleation due to tumor growth after brachytherapy. At present, only one patient has died during follow-up due to liver metastases six years after the start of treatment. In carefully selected patients, this approach can be effective and safe, as long as a close follow-up is carried out after surgery.

show abstract

Clinical outcomes of Modified Collaborative Ocular Melanoma Study IRIS plaques for treatment of iris, iridociliary, and ciliary body melanoma

Cited by 8 publications

References 24 publications

Anterior plaque brachytherapy placement for treatment of iris and iridociliary melanomas – Surgical procedure and institutional experience

Anterior plaque brachytherapy placement for treatment of iris and iridociliary melanomas – Surgical procedure and institutional experience

Uveal melanoma: laboratory advances and new frontiers in patient care

Clinical Outcomes after Surgical Resection Combined with Brachytherapy for Uveal Melanomas

Contact Info

Product

Resources

About