Dosimetric comparison of circular Eye Physics and Collaborative Ocular Melanoma Study plaques to treat uveal melanoma

Dean, Mary K.; Studenski, Matthew T.; Paez-Escamilla, Manuel; Walter, Scott D.; Kwon, Deukwoo; Markoe, Arnold M.; Harbour, J. William; Samuels, S.

doi:10.1016/j.brachy.2019.01.005

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…Other studies have reported no difference in outcomes using EP plaques compared with COMS plaques, 31 , 32 suggesting that the choice of plaque can be made based on cost or surgeon preference. 32 It is worth emphasizing that key differences between COMS and EP plaques preclude a comparison of outcomes based on prescribed radiation doses. It is estimated that the silastic insert in which the 125 I seeds are loaded in COMS plaques attenuates around 10% of the prescribed dose.…”

Section: Discussionmentioning

confidence: 95%

“…Marwaha et al reported on a type of EP plaque (EP917) that uses fewer radiation seeds on average with less radiation exposure to the optic disc and macula while maintaining a therapeutic dose to the tumor (30). Other studies have reported no difference in outcomes using EP plaques compared to COMS plaques (31,32), suggesting that the choice of plaque can be made based on cost or surgeon preference (32). It is worth emphasizing that key differences between COMS and EP plaques precludes a comparison of outcomes based on prescribed radiation doses.…”

Section: Discussionmentioning

confidence: 99%

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Preliminary Results of Uveal Melanoma Treated With Iodine-125 Plaques: Analysis of Disease Control and Visual Outcomes With 63 Gy to the Target Volume

Kheir¹,

Stinnett²,

Meltsner

et al. 2022

Advances in Radiation Oncology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Preliminary Results of Uveal Melanoma Treated With Iodine-125 Plaques: Analysis of Disease Control and Visual Outcomes With 63 Gy to the Target Volume

Kheir¹,

Stinnett²,

Meltsner

et al. 2022

Advances in Radiation Oncology

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show abstract

“…There have been a number of papers published on the use of these plaques in clinical practice without any explicit discussion about FDA approval. 13,14,22,23 As far as the authors are aware, this is the only publication to specifically address how we approached the use of these plaques at our institution.…”

Section: Address Fda Approval Of Treatment Planning System and Plaquesmentioning

confidence: 99%

“…Our decision to clinically use this plaque and planning system was also influenced by other institutions, as the PS TPS and the EP plaques have been used extensively in the field since 1990, 13,14 despite the lack of FDA approval. There have been a number of papers published on the use of these plaques in clinical practice without any explicit discussion about FDA approval 13,14,22,23 . As far as the authors are aware, this is the only publication to specifically address how we approached the use of these plaques at our institution.…”

Section: Introductionmentioning

confidence: 99%

Transitioning from a COMS‐based plaque brachytherapy program to using eye physics plaques and plaque simulator treatment planning system: A single institutional experience

Meltsner

Rodrigues

Materin

et al. 2023

J Applied Clin Med Phys

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The aim of this work is to describe the implementation and commissioning of a plaque brachytherapy program using Eye Physics eye plaques and Plaque Simulator treatment planning system based on the experience of one institution with an established COMS-based plaque program. Although commissioning recommendations are available in official task groups publications such as TG-129 and TG-221, we found that there was a lack of published experiences with the specific details of such a transition and the practical application of the commissioning guidelines. The specific issues addressed in this paper include discussing the lack of FDA approval of the Eye Physics plaques and Plaque Simulator treatment planning system, the commissioning of the plaques and treatment planning system including considerations of the heterogeneity corrected calculations, and the implementation of a second check using an FDA-approved treatment planning system. We have also discussed the use of rental plaques, the analysis of plans using dose histograms, and the development of a quality management program. By sharing our experiences with the commissioning of this program this document will assist other institutions with the same task and act as a supplement to the recommendations in the recently published TG-221.

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“…The eye physics plaque model 917 stands out, reducing the dose absorbed by the optic nerve and fovea by an average of 42% and 49%, respectively, compared to a COMS plaque, while delivering 85 Gy prescription dose at the apex. [ 24a,26 ] However, this design is an improved version of the one proposed by COMS (e.g., stacking the same sources), so it suffers from the same limitations.…”

Section: Introductionmentioning

confidence: 99%

Tumor Shape‐Specific Brachytherapy Implants by 3D‐Printing, Precision Radioactivity Painting, and Biomedical Imaging

Lescot

Lebel-Cormier

Seniwal

et al. 2023

Adv Healthcare Materials

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In brachytherapy, or internal radiation therapy, cancer is treated by inserting radioactive implants in or close to the tumors. These implants, such as episcleral plaques for the treatment of uveal melanoma, are designed according to generic population approximations. However, implants more personalized to the anatomy and to the precise geometry of each patient's tumor, could enhance treatment precision by allowing better adjustment of dose profiles to the contours of cancerous tissues. This work describes an original approach integrating biomedical imaging, 3D printing, radioactivity painting, and anatomical measurement of biomedical imaging, as a workflow for the development of tumor shape‐specific brachytherapy implants. A case study is carried out on the fabrication of radioactive episcleral plaques (EP) for the treatment of uveal melanoma. First, computer‐aided design (CAD) plans of EP are prepared according to guidelines prescribed by the Collaborative Ocular Melanoma Study (COMS) protocol. Polyetheretherketone (PEEK), a high‐performance polymer suitable for permanent implants, is used to 3D‐print plaques (10‐, 14‐ or 22‐mm diameter EPs) according to these CAD plans and the geometrical accuracy of the printed design is evaluated. The possibility to modulate the dose distribution is demonstrated by painting the inner surfaces of the EPs with radioactive 103Pd in different patterns, followed by dose profile measurements. The approach confirms the possibility to modulate the dose distribution generated by 3D‐printed plaques through radioactivity painting. Lastly, the suitability of the 3D‐printed plaques for surgical manipulations is demonstrated by performing ex vivo surgical tests on human eyeballs. This new workflow for the fabrication of tumor‐specific radioactive implants may improve the precision of a range of different brachytherapy procedures that require more personalized anatomical adjustments with the geometry of tumors and organs at risk .This article is protected by copyright. All rights reserved

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Dosimetric comparison of circular Eye Physics and Collaborative Ocular Melanoma Study plaques to treat uveal melanoma

Cited by 7 publications

References 19 publications

Preliminary Results of Uveal Melanoma Treated With Iodine-125 Plaques: Analysis of Disease Control and Visual Outcomes With 63 Gy to the Target Volume

Preliminary Results of Uveal Melanoma Treated With Iodine-125 Plaques: Analysis of Disease Control and Visual Outcomes With 63 Gy to the Target Volume

Transitioning from a COMS‐based plaque brachytherapy program to using eye physics plaques and plaque simulator treatment planning system: A single institutional experience

Tumor Shape‐Specific Brachytherapy Implants by 3D‐Printing, Precision Radioactivity Painting, and Biomedical Imaging

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