Histopathologic Changes Following Irradiation for Uveal Tract Melanoma

Petrovich, Zbigniew; McDonnell, Jan M.; Palmer, Daphne; Langholz, Bryan; Liggett, Peter E.

doi:10.1097/00000421-199408000-00004

Cited by 18 publications

(11 citation statements)

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“…[60][61][62] Petrovich et al 63 described the histologic appearance of enucleated eyes with choroidal melanoma that had been treated with plaque brachytherapy. Scleral atrophy was seen in 33% of post-plaque eyes.…”

Section: Scleral Necrosismentioning

confidence: 99%

Ocular complications following I-125 brachytherapy for choroidal melanoma

Wen

Oliver

McCannel

2009

Eye

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Uveal melanoma has traditionally been treated with enucleation, plaque brachytherapy, or external beam radiation. Following the results of the multicenter Collaborative Ocular Melanoma Study (COMS), which established no significant difference in mortality rates between enucleation and brachytherapy, plaque brachytherapy has become the favoured modality given its potential for preservation of vision and the eye. Among the radioisotopes that have been used, iodine-125 (I-125) has become the increasingly popular choice in the United States. However, I-125 brachytherapy is associated with complications, including keratitis, iris neovascularization, neovascular glaucoma, radiation retinopathy, and optic neuropathy. The purpose of this review is to discuss the pathogenesis, clinical presentation, and management of complications related to I-125 plaque brachytherapy for choroidal melanoma.

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Section: Scleral Necrosismentioning

confidence: 99%

Ocular complications following I-125 brachytherapy for choroidal melanoma

Wen

Oliver

McCannel

2009

Eye

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“…However, scleral atrophy and necrosis (Fig. 6) have been reported to occur in eyes receiving radiotherapy (Tarr & Constable 1980; Petrovich et al. 1994; Shields et al.…”

Section: Complications Of Ocular and Periocular Radiotherapymentioning

confidence: 99%

“…Scleral atrophy and necrosis are serious dose‐limiting factors in episcleral brachytherapy. One study reported the incidence of histological scleral atrophy in 38 enucleated eyes that had undergone EBRT, brachytherapy or enucleation alone for uveal melanoma. Scleral atrophy was present in 33% of eyes treated with brachytherapy and in none treated with EBRT or enucleation alone (Petrovich et al. 1994).…”

Section: Complications Of Ocular and Periocular Radiotherapymentioning

confidence: 99%

Ophthalmic and adnexal complications of radiotherapy

Durkin

Roos

Higgs

et al. 2006

Acta Ophthalmologica Scandinavica

133

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ABSTRACT.The role of radiotherapy in ophthalmic practice continues to grow. This growth has seen an expansion of indications for radiotherapy, a refinement of the modalities that can be used and a reduction in the ocular and adnexal complications that result from this form of therapy. The compendium of indications for radiotherapy in ophthalmology continues to grow and now includes many conditions such as the treatment of lid and adnexal disease, ocular surface disorders and both benign and malignant disease of the posterior segment and optic pathways. The radiotherapeutic modalities employed to manage these conditions are numerous and include both radioactive plaques (brachytherapy) and external beam radiation techniques. New techniques such as stereotactic radiosurgery are delivering benefits in the management of conditions such as optic nerve sheath meningioma, where the treatment of this blinding and occasionally life-threatening intracranial neoplasm now results in fewer adverse affects. The purpose of this review is to give a brief overview of the indications and treatment modalities, and a more in-depth discussion of the potential side-effects when radiotherapy is used for ocular and periorbital disease.

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“…Thereafter, another 170 such pathological studies have been reported [24][25][26][27][28][29][30][31]. A substantial number of irradiated tumours are treated successfully, but the actual percentage of loss of proliferative capacity of all stem cells will never be known.…”

Section: Tumour Biology In Relation To Ionising Radiationmentioning

confidence: 99%

Uveal melanoma: updated considerations on current management modalities

1995

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Published data on growth rates of uveal melanomas and effects of treatment modalities raise important considerations. Dissemination from uveal melanomas starts after the tumour is larger than 7 mm diameter; growth from 7 to 10 mm diameter increases the risk of metastases incrementally to approximately 16%. Estimations of turnout doubling times indicate that metastatic death before 8 years is nearly always due to pre-therapeutic dissemination so that the impact on survival by therapy can only be assessed thereafter. Histopathology on irradiated melanomas reveals that reproductive activity has not been suppressed and the anticipated (and unfavourable) risk of metastases is not balanced by poor post-irradiation visual acuity. Also the psychological well-being of a patient with a functional fellow eye is better after primary enucleation. Conservative management is most appropriate for: small melanomas, patients with a short life expectancy, melanomas in a single functioning eye, and patients refusing enucleation.Optimum treatment of any form of neoplastic disease by modern therapeutic modalities should ideally be based on an accurate knowledge of the biological behaviour of the specific neoplastic process. With regard to ocular melanomas, there are serious gaps in knowledge concerning growth rates in situ and in the documentation of the time intervals between the presentation of the primary tumour and the appearance of metastases. The rarity of the tumour necessitates careful accumulation of data, so that an adequate analysis can be made of the claimed success of cure rates. Equally important, the side effects and the complications of treatment should be the subject of careful scrutiny. In this communication the literature on the relevant aspects of melanoma biology and current treatment modalities is critically analysed. Tumour biology Tumour doubling timeInformation on tumour doubling time of uveal melanomas was introduced in 1980 [1] and updated reviews were provided in 1987 [2] and in 1992 [3]. From this data it was possible to estimate the risk of metastatic disease in relation to the dimensions of the tumour. The application of meta analysis provided by Diener-West and associates [4] and Markowitz et al. [5] has indicated that a radical reappraisal of the current philosophy of management is required. When do uveal melanomas metastasize ?In 1984, an editorial in the American Journal of Ophthalmology stated that 'it is unclear at what stage in its course a uveal melanoma develops the capacity to metastasize ' [6]. However an analysis of the data then available in the literature provided evidence which indicated that metastatic disease does not occur until

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Histopathologic Changes Following Irradiation for Uveal Tract Melanoma

Cited by 18 publications

References 0 publications

Ocular complications following I-125 brachytherapy for choroidal melanoma

Ocular complications following I-125 brachytherapy for choroidal melanoma

Ophthalmic and adnexal complications of radiotherapy

Uveal melanoma: updated considerations on current management modalities

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