Radiobiological doses, tumor, and treatment features influence on local control, enucleation rates, and survival after epiescleral brachytherapy. A 20-year retrospective analysis from a single-institution: part I

Miguel, David; Frutos-Baraja, Jesús María de; López-Lara, Francisco; Saornil, María A.; García-Álvarez, C.; Alonso, Pilar; Diezhandino, Patricia

doi:10.5114/jcb.2018.77849

Cited by 19 publications

(32 citation statements)

References 54 publications

(71 reference statements)

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“…Co-founding factors that affect treatment outcomes among different studies include the selection of patients, tumor characteristics and the definition of the recurrence rate. [11,7]. A meta-analysis of CPT involving 7500 patients in 28 studies also revealed a low ocular toxicity similar to our study.…”

Section: Discussionsupporting

confidence: 90%

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106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma

Jiang

Purtskhvanidze

Kandzia

et al. 2020

Preprint

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Background: To evaluate 106Ruthenium Brachytherapy in management of medium sized uveal melanoma, with emphasis on 5-year outcome and toxicity.Methods: From 2007 to 2015, 39 patients were treated with 106 Ru eye plaques brachytherapy. At the time of diagnosis, the median tumor depth was 3.0 mm (CI: 1.6-8.9 mm). Median dose at the apex of the tumor was 145 Gy (± SD: 12.1Gy). The median sclera dose was 444.0Gy (±SD: 257.3 Gy). Results: Median follow-up was 61.5 months (CI: 8.1-138 mon.). 34 patients (87.1%) remained free of recurrence. In 26 (66.7%) patients a total regression was achieved after a median period of 12 months (CI: 3-60 mon.). By the final examination, the visual acuity of 26 (66.7%) patients was better than 20/200. 12 (30.7%) patients had a visual acuity better than 20/40.Retinopathy was detected in 11 (28.2%) patients. After treatments only 1 (5.1%) patients had active vascular changes by the last examination. Moderate optic neuropathy was observed in 4 (10.3%) patients. Cataract development was diagnosed in 21 (53.8%) patients, although 16 (41%) of them had bilateral cataract development.Special emphasis was made on patients with larger tumors. Twelve out of the 39 patients had a tumor with a depth of 5mm or more. There was no significant difference neither in local control (75 % in tumors ≥5mm versus 92.6 % in tumors <5mm) nor in side effects between both groups. Conclusions: Our study proved 106 Ru -brachytherapy to be an excellent treatment option with regard to tumor control and preservation of the visual acuity in well-selected patients. The data suggest that this treatment is also suitable for tumors with a depth of more than 5mm.

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Section: Discussionsupporting

confidence: 90%

“…However, the local control failure of COMS study was defined as the progression of the height of the tumor in 25%. When 125 I plaque therapy was applied, the rates of tumor controlling vary from 88.2-94% in diverse studies [5,6,7]. The 5-year local recurrence rate of CPT was around 5% [8,9,10].…”

Section: Discussionmentioning

confidence: 99%

106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma

Jiang

Purtskhvanidze

Kandzia

et al. 2020

Preprint

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“…Recently studies indicated that 106 Ru eye plaque brachytherapy generally causes fewer late complications than 125 I therapy [12,8]. A meta-analysis of CPT involving 7500 patients in 28 studies also revealed a low ocular toxicity similar to our study.…”

Section: Patient Characteristicssupporting

confidence: 88%

“…However, the local control failure of COMS study was de ned as the progression of the height of the tumor in 25%. When 125 I plaque therapy was applied, the rates of tumor controlling vary from 88.2% to 94% in diverse studies [6,7,8]. The 5-year local recurrence rate of CPT was around 5% [9,10,11].…”

Section: Patient Characteristicsmentioning

confidence: 99%

106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma

Jiang

Purtskhvanidze

Kandzia

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: To evaluate 106 Ruthenium Brachytherapy in management of medium sized uveal melanoma, with emphasis on 5-year outcome and toxicity. Methods: From 2007 to 2015, 39 patients were treated with 106 Ru eye plaques brachytherapy. At the time of diagnosis, the mean tumor depth was 3.7 mm (±SD:1.6). Mean dose at the apex of the tumor was 141.4 Gy (± SD: 12.1 Gy). The mean sclera dose was 557.7 Gy (± SD: 257.3 Gy). Results: Mean follow-up was 69.5 months (± SD: 53.8 months). 34 patients (87.1%) remained free of recurrence. In 26 (66.7%) patients a total regression was achieved after a median period of 12 months (Range: 3-60 mon.). By the final examination, the visual acuity of 26 (66.7%) patients was better than 20/200. 12 (30.7%) patients had a visual acuity better than 20/40. Retinopathy was detected in 11 (28.2%) patients. After treatments only 1 (5.1%) patients had active vascular changes by the last examination. Moderate optic neuropathy was observed in 4 (10.3%) patients. Cataract development was diagnosed in 21 (53.8%) patients, although 16 (41%) of them had bilateral cataract development. Special emphasis was made on patients with larger tumors. Twelve out of the 39 patients had a tumor with a depth of 5mm or more. There was no significant difference neither in local control (75 % in tumors ≥5mm versus 92.6 % in tumors <5mm) nor in side effects between both groups. Conclusions: Our study proved 106 Ru -brachytherapy to be an excellent treatment option with regard to tumor control and preservation of the visual acuity in well-selected patients. The data suggest that this treatment is also suitable for tumors with a depth of more than 5mm.

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“…The work by Miguel et al evaluating 20-year results of the treatment of uveal melanoma observed that the necessity of enucleation of an eyeball occurs significantly more frequently Application time (hours) < 52 52-71.9 72-95.9 ≥96 < 52 -censored 52-71.9 -censored 72-95.9 -censored ≥ 96 censored in the case of dome-shaped tumours than in the case of a mushroom-like shape (p = 0.002). These authors however did not find any correlation between the shape of the tumour and an increased risk of local relapse [21].…”

Section: Discussionmentioning

confidence: 81%

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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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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Radiobiological doses, tumor, and treatment features influence on local control, enucleation rates, and survival after epiescleral brachytherapy. A 20-year retrospective analysis from a single-institution: part I

Cited by 19 publications

References 54 publications

106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma

106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma

106Ruthenium eye plaque brachytherapy in the management of medium sized uveal melanoma

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

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