Radiological and clinical findings in uveal melanoma treated by plaque interventional radiotherapy (brachytherapy): Visual atlas and literature review on response assessment

Fionda, Bruno; Pagliara, Monica Maria; Lancellotta, Valentina; Caputo, Carmela; Casà, Calogero; Sammarco, Maria Grazia; Placidi, E.; Cornacchione, Patrizia; Boselli, Francesco; Iezzi, Roberto; Colosimo, Cesare; Tagliaferri, Luca; Blasi, Maria Antonietta

doi:10.5114/jcb.2022.113271

Cited by 6 publications

(4 citation statements)

References 35 publications

(36 reference statements)

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“…For conjunctival melanoma, the literature describes two such cases treated with a target dose of 34 Gy over the course of 5 days. Both cases presented a great outcome, without important side effects or long-term consequences [23,29].…”

Section: Discussionmentioning

confidence: 99%

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H-VISTA Immunohistochemistry Score Is Associated with Advanced Stages in Cutaneous and Ocular Melanoma

Tinca,

Szoke,

Lazar

et al. 2024

IJMS

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Melanoma represents a public health issue. One of the biggest goals of current research is to develop new therapeutic options for patients affected by this aggressive tumor. We conducted a retrospective study including 105 patients diagnosed with cutaneous and ocular melanoma, with stages varying from pT1a to pT4b and pT4e, respectively, and we performed immunohistochemistry reactions with the new potential prognostic marker, VISTA (V-domain Ig suppressor of T cell activation). We quantified the expression by applying the H-score adapted for VISTA and divided the patients, based on the median value, into groups that presented high, low, and negative expression. Therefore, we obtained 65 cases with positive expression for cutaneous melanoma and 8 cases with positive expression for ocular melanoma. Forty-one cases presented high expression in cutaneous melanoma and three cases presented high expression in ocular melanoma. In cutaneous melanoma, analytic statistics showed that VISTA expression was associated with a high Breslow index, high mitotic count, high Ki67 expression, and advanced clinicopathological stage. The majority of ocular melanoma cases demonstrating a positive reaction were classified as stage pT3, whereas earlier stages showed a negative reaction. Our findings underscore a significant correlation between VISTA expression and key prognostic factors in melanoma. Looking ahead, the prospect of future randomized studies holds promise in corroborating the clinical relevance of our findings. By further elucidating the intricate relationship between VISTA expression and melanoma progression, new treatment strategies could be found, improving patient outcomes in this challenging neoplasm.

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Section: Discussionmentioning

confidence: 99%

“…Nevertheless, based on the findings and the impact on patients' prognosis and quality of life, IRT is a valuable therapeutic option, and it should be recommended on a large scale. High-dose-rate interventional radiotherapy is an important procedure that can be used for other types of ocular melanoma, such as conjunctival melanoma [23,24].…”

Section: Introductionmentioning

confidence: 99%

H-VISTA Immunohistochemistry Score Is Associated with Advanced Stages in Cutaneous and Ocular Melanoma

Tinca,

Szoke,

Lazar

et al. 2024

IJMS

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“…A reduction in tumour prominence or volume, as obtained by ultrasound, is clinically one of the primary signs of therapy response [46,[159][160][161]. In general, a rapid reduction in tumour prominence is observed after brachytherapy, while after ocular proton beam therapy, an initial stable of even a temporarily increase in prominence is not uncommon.…”

Section: Follow-upmentioning

confidence: 99%

Magnetic Resonance Imaging in the Clinical Care for Uveal Melanoma Patients—A Systematic Review from an Ophthalmic Perspective

Jaarsma-Coes

Klaassen

Marinković

et al. 2023

Cancers

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Conversely to most tumour types, magnetic resonance imaging (MRI) was rarely used for eye tumours. As recent technical advances have increased ocular MRI’s diagnostic value, various clinical applications have been proposed. This systematic review provides an overview of the current status of MRI in the clinical care of uveal melanoma (UM) patients, the most common eye tumour in adults. In total, 158 articles were included. Two- and three-dimensional anatomical scans and functional scans, which assess the tumour micro-biology, can be obtained in routine clinical setting. The radiological characteristics of the most common intra-ocular masses have been described extensively, enabling MRI to contribute to diagnoses. Additionally, MRI’s ability to non-invasively probe the tissue’s biological properties enables early detection of therapy response and potentially differentiates between high- and low-risk UM. MRI-based tumour dimensions are generally in agreement with conventional ultrasound (median absolute difference 0.5 mm), but MRI is considered more accurate in a subgroup of anteriorly located tumours. Although multiple studies propose that MRI’s 3D tumour visualisation can improve therapy planning, an evaluation of its clinical benefit is lacking. In conclusion, MRI is a complementary imaging modality for UM of which the clinical benefit has been shown by multiple studies.

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“…According to the COMS classification system, brachytherapy was indicated in the following three conditions: small melanomas, with a documented tendency to grow or with clear signs of activity; all medium-sized melanomas; and some large melanomas, with a reasonable potential for preserving vision upon patient consent [4,5]. Although this procedure is effective, it can lead to various ocular complications [6][7][8], and often results in significant loss of visual acuity (VA) because of high radiation dose. There are several reasons for this, but the main side effects include retinopathy, maculopathy, cataract, neovascular glaucoma, and nerve atrophy.…”

Section: Purposementioning

confidence: 99%

A study comparing baseline and best-corrected visual acuity after iodine-125 episcleral brachytherapy in uveal melanoma

Miguel,

de Frutos,

Alonso

et al. 2023

jcb

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Purpose:The aim of this study was to analyze the course of visual acuity (VA) in visual outcomes of patients treated with iodine-125 ( 125 I) brachytherapy in our center, based on original VA before treatment.Material and methods: Visual acuity was prospectively assessed using a case series of 305 patients treated with 125 I between 1996 and 2022. To examine how VA behaves over time, we divided patient sample into 4 groups: (1) Patients with visual acuity of less than V ≤ 0.1 at baseline; (2) Patients with low to moderate VA, ranging 0.1 < V < 0.4; (3) Patients with moderate-high VA, ranging 0.4 < V < 0.8; (4) Patients with very high VA of V > 0.8. Each of the four groups was studied separately over a 60-month period to determine the percentage of patients with VA improvement, worsening, or with the same VA status. Finally, visual outcomes over time were estimated with 95% confidence interval (CI) using Kaplan-Meier analysis, and VA maintenance rates were reported at 1, 3, 5, 10, 15, and 20 years of follow-up.Results: The median follow-up time was 78.2 months (range, 6-254 months). The cumulative probabilities of survival analysis at 1, 3, 5, and 10 years were 16%, 3%, 2%, and none for the first sub-group; 46%, 20%, 17%, and 14% for the second; 65%, 53%, 29%, and 15% for the third; and 86%, 56%, 48%, and 41% for the fourth sub-group. The median survival in years was 0.30, 0.80, 3.10, and 4.40 for each sub-cohort, respectively.Conclusions: The decrease and maintenance of VA depends on the initial VA of patients. Most patients experience a marked worsening of their VA, regardless of their VA status before treatment with episcleral brachytherapy. Patients with a higher baseline VA retain VA best over time.

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Radiological and clinical findings in uveal melanoma treated by plaque interventional radiotherapy (brachytherapy): Visual atlas and literature review on response assessment

Cited by 6 publications

References 35 publications

H-VISTA Immunohistochemistry Score Is Associated with Advanced Stages in Cutaneous and Ocular Melanoma

H-VISTA Immunohistochemistry Score Is Associated with Advanced Stages in Cutaneous and Ocular Melanoma

Magnetic Resonance Imaging in the Clinical Care for Uveal Melanoma Patients—A Systematic Review from an Ophthalmic Perspective

A study comparing baseline and best-corrected visual acuity after iodine-125 episcleral brachytherapy in uveal melanoma

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