Iodine-125 Brachytherapy for Uveal Melanoma: A Systematic Review of Radiation Dose

Echegaray, Jose J.; Bechrakis, Nikolaos E.; Singh, Nakul; Bellerive, Claudine; Singh, Arun D.

doi:10.1159/000455872

Cited by 35 publications

(17 citation statements)

References 31 publications

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“…The mean dose applied to the top of the tumour did not have any effect on the occurrence of local relapse in our patients. Some similar observations were made by Echegaray et al in a meta-analysis of 15 reports in which they observed a tendency of local relapse to decrease by 0.14% with a dose increase by 1 Gy to the top of the tumour, yet this result was not statistically significant (p = 0.336) [22].…”

Section: Discussionsupporting

confidence: 74%

Analysis of local recurrence causes in uveal melanoma patients treated with 125I brachytherapy – a single institution study

Kowal¹,

Markiewicz²,

Dębicka-Kumela³

et al. 2019

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Purpose: To perform a retrospective analysis of factors which might affect the occurrence of a relapse of uveal melanoma after 125 I brachytherapy. Material and methods: The analysis concerned 343 patients treated in the years 2001-2012. The effect on local recurrence of such factors as patient's sex, age, tumour size, shape, pigmentation, location, presence of orange pigment or petechiae on tumour surface, retinal detachment, and blood or dispersed pigment in vitreous body were studied. Additional analysis concerned physical properties of brachytherapy (total dose, irradiation dose applied to tumour apex and base and irradiation time). Two groups of patients were distinguished: with and without a relapse. The diagnostic criterion for the relapse was growth of the tumour base or height by 0.5 mm. Results: Local recurrence of the uveal melanoma was observed in 29 patients (8.5%). Recurrences occurred with significantly higher frequency (p < 0.001), when the anterior tumour edge involved the ciliary body. Patients' survival in relation to the moment the occurrence of the relapse was statistically significant for application time (p = 0.004) and tumour pigmentation (p = 0.010). The deaths of patients with a local relapse were most rare when brachytherapy lasted from 72 to 95.9 hours and most frequent in cases of brownish tumour pigmentation. Patient sex, tumour shape and size, presence of orange pigment, retinal detachment, petechiae and bleeding to vitreous body as well as the dose of irradiation to tumour top and base did not have any significant effect on relapse occurrence. Conclusions: Treatment of uveal melanomas with 125 I applicators allows for a high rate of positive local results. Nonetheless, the recurrence probability always exists. The involvement of the ciliary body could influence this. The survival depending on the time of relapse could be statistically significant for application time and dark-brown tumour pigmentation.

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Section: Discussionsupporting

confidence: 74%

Analysis of local recurrence causes in uveal melanoma patients treated with 125I brachytherapy – a single institution study

Kowal¹,

Markiewicz²,

Dębicka-Kumela³

et al. 2019

jcb

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“…Thanks to the current methods of uveal melanoma treatment, the rate of positive effects of local treatment is about 76–100% 9,10 . Unfortunately, there are still no effective treatment methods which would allow to cure the disease completely or to prolong significantly the survival of the patients in whose case tumor spread occurred.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D receptors (VDR), hydroxylases CYP27B1 and CYP24A1 and retinoid-related orphan receptors (ROR) level in human uveal tract and ocular melanoma with different melanization levels

Markiewicz

Brożyna

Podgórska

et al. 2019

Sci Rep

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In recent years, a significant number of studies have investigated the preventive role of vitamin D in a number of different neoplasms. In this study, we analyze various components of the vitamin D signaling pathways in the human uveal tract and uveal melanoma, including analysis of the expression of vitamin D receptors (VDR), the activating and inactivating hydroxylases, respectively, CYP27B1 and CYP24A1, and the retinoic acid-related orphan receptors (ROR) α (RORα) and γ (RORγ) in these tissues. We further analyzed the expression of VDR, CYP27B1, CYP24A1, and ROR in relation to melanin levels, clinical stage and prognosis. Our study indicated that the uveal melanoma melanin level inversely correlated with VDR expression. We further showed that vitamin D is metabolized in uveal melanoma. This is significant because until now there has been no paper published, that would describe presence of VDR, hydroxylases CYP27B1 and CYP24A1, and RORα and RORγ in the human uveal tract and uveal melanomas. The outcomes of our research can contribute to the development of new diagnostic and therapeutic methods in uveal tract disorders, especially in uveal melanoma. The presented associations between vitamin D signaling elements and uveal melanoma in comparison to uveal tract encourage future clinical research with larger patients’ population.

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“…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% [27].…”

Section: Discussionmentioning

confidence: 99%

“…The objective of the study was to evaluate outcomes of I-125 brachytherapy treatment of patients with uveal melanoma, taking into account the relationship between results and the dose applied to the tumor apex [25,26,27].…”

Section: Purposementioning

confidence: 99%

Outcomes of I-125 brachytherapy for uveal melanomas depending on irradiation dose applied to the tumor apex – a single institution study

Kowal¹,

Markiewicz²,

Dębicka-Kumela³

et al. 2018

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PurposeThe aim of the study was an evaluation of I-125 brachytherapy patients with uveal melanoma with special consideration for the relationship of the treatment results and the irradiation dose applied to the tumor apex.Material and methodsMedical records of 344 adults with uveal melanoma treated with I-125 brachytherapy in the Department of Ophthalmology and Ocular Oncology of the Jagiellonian University, Medical College in Cracow, Poland were retrospectively analyzed. The study was conducted between 2003 and 2012, and the study group was divided into two subgroups depending on the irradiation dose applied to the top of the tumor: 80 Gy to 100 Gy (n = 177) and 100 Gy to 120 Gy (n = 167).ResultsIt was found that the height of the tumor and the largest diameter of the tumor base decreased with every consecutive follow-up measurement and differed significantly in all comparisons (p < 0.0001). No significant correlation between frequency of complications was found between both study groups (χ2 = 0.27; p = 0.6067). The correlation between survival and the irradiation dose as applied to the tumor top was statistically irrelevant (χ2 = 0.44; p = 0.5084). A logistic regression model showed that patient survival depended on the largest diameter of the base and the height of tumor (p = 0.0216), and the risk of death was larger as these dimensions increased (IR, 1.17). An increase of the largest diameter of the base by 1 mm meant a 17% increase in chances of death. In 13.4% of cases, an enucleation was necessary.ConclusionsThe treatment of choroidal melanomas with I-125 iodine isotope brachytherapy is an efficient and recommended method of treatment and in many cases, an alternative to the enucleation of an eyeball.

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Iodine-125 Brachytherapy for Uveal Melanoma: A Systematic Review of Radiation Dose

Cited by 35 publications

References 31 publications

Analysis of local recurrence causes in uveal melanoma patients treated with 125I brachytherapy – a single institution study

Analysis of local recurrence causes in uveal melanoma patients treated with 125I brachytherapy – a single institution study

Vitamin D receptors (VDR), hydroxylases CYP27B1 and CYP24A1 and retinoid-related orphan receptors (ROR) level in human uveal tract and ocular melanoma with different melanization levels

Outcomes of I-125 brachytherapy for uveal melanomas depending on irradiation dose applied to the tumor apex – a single institution study

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