The American Brachytherapy Society recommendations for brachytherapy of uveal melanomas

Nag, Subir; Quivey, Jeanne M.; Earle, John D.; Followill, David S; Fontanesi, James; Finger, Paul T.

doi:10.1016/s0360-3016(03)00006-3

Cited by 222 publications

(170 citation statements)

References 92 publications

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“…A major concern for the use of 106 Ru plaques is its steep dose gradient in large tumors, meaning that the radiation dose falloff is quick, and in large UMs, the apex dose may not reach the recommended dose of 85 Gy [11]. Thus, some authors believe that 106 Ru plaques are not suitable for tumors with a thickness of 7 mm or more because the high dose to the outer sclera is a concern [12,13,14]. In contrast, multiple clinical studies have shown that 106 Ru brachytherapy can result in a favorable clinical outcome and complete regression even in large tumors [15,16].…”

Section: Purposementioning

confidence: 99%

Ruthenium-106 brachytherapy for thick uveal melanoma: reappraisal of apex and base dose radiation and dose rate

Naseripour¹,

Jaberi²,

Sedaghat³

et al. 2016

jcb

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Purpose: To evaluate the outcomes of ruthenium-106 ( 106 Ru) brachytherapy in terms of radiation parameters in patients with thick uveal melanomas.Material and methods: Medical records of 51 patients with thick (thickness ≥ 7 mm and < 11 mm) uveal melanoma treated with 106 Ru brachytherapy during a ten-year period were reviewed. Radiation parameters, tumor regression, best corrected visual acuity (BCVA), and treatment-related complications were assessed.Results: Fifty one eyes of 51 consecutive patients including 25 men and 26 women with a mean age of 50.5 ± 15.2 years were enrolled. Patients were followed for 36.1 ± 26.5 months (mean ± SD). Mean radiation dose to tumor apex and to sclera were 71 (± 19.2) Gy and 1269 (± 168.2) Gy. Radiation dose rates to tumor apex and to sclera were 0.37 (± 0.14) Gy/h and 6.44 (± 1.50) Gy/h. Globe preservation was achieved in 82.4%. Preoperative mean tumor thickness of 8.1 (± 0.9) mm decreased to 4.5 (± 1.6) mm, 3.4 (± 1.4) mm, and 3.0 (± 1.46) mm at 12, 24, and 48 months after brachytherapy (p = 0.03). Four eyes that did not show regression after 6 months of brachytherapy were enucleated. Secondary enucleation was performed in 5 eyes because of tumor recurrence or neovascular glaucoma. Tumor recurrence was evident in 6 (11.8%) patients. Mean Log MAR (magnification requirement) visual acuity declined from 0.75 (± 0.63) to 0.94 (± 0.5) (p = 0.04). Best corrected visual acuity of 20/200 or worse was recorded in 37% of the patients at the time of diagnosis and 61.7% of the patients at last exam (p = 0.04). Non-proliferative and proliferative radiation-induced retinopathy was observed in 20 and 7 eyes.Conclusions: Thick uveal melanomas are amenable to 106 Ru brachytherapy with less than recommended apex radiation dose and dose rates.

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Section: Purposementioning

confidence: 99%

Ruthenium-106 brachytherapy for thick uveal melanoma: reappraisal of apex and base dose radiation and dose rate

Naseripour¹,

Jaberi²,

Sedaghat³

et al. 2016

jcb

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“…11,12 The visual results in our study may also be influenced by the prescription dose of 100 Gy to the tumour apex, which is somewhat higher than that recently recommended. 13 Radiation-related maculopathy and optic neuropathy were the main causes of visual loss. The patients who developed neuropathy had a median dose of 55 Gy to the centre of the optic disc.…”

Section: Discussionmentioning

confidence: 99%

Posterior uveal melanoma treated with I-125 brachytherapy or primary enucleation

Krohn

Monge

Skorpen

et al. 2007

Eye

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Purpose To study the incidence, clinical findings, and tumour characteristics of posterior uveal melanoma in Western Norway, and to report the results of a consistent treatment strategy (I-125 brachytherapy or primary enucleation) over a 13-year period. Methods The clinical records of all patients with posterior uveal melanoma referred between January 1993 and December 2005 were reviewed. Clinical data, radiation parameters, visual outcome, and mortality were analysed in a dedicated database. Results The study included 111 consecutive patients. The annual age-adjusted incidence (per million population) of posterior uveal melanoma was 8.5 for women and 8.9 for men. Fifty-six patients underwent I-125 brachytherapy, 52 were enucleated, and three received no treatment. The median follow-up time was 36 months (mean, 52 months; range, 2 months to 13 years). In the brachytherapy group, two eyes were enucleated owing to tumour recurrence and two because of neovascular glaucoma. A visual acuity of 0.1 or better, present in 87% of the patients before brachytherapy, was retained in 40% after a median follow-up of 61 months. After brachytherapy, the 5-and 10-year melanomaspecific mortality rates were 13.4 and 23.8%, respectively. The corresponding mortality rates for patients treated with primary enucleation were 49.5 and 49.5%. Conclusion After brachytherapy, many patients lost useful vision due to radiationinduced complications. The probability of retaining the eye was high and only two patients experienced recurrent tumour growth. The mortality rates compare well with published series, and the differences in tumour size explain the difference in mortality between the two treatment groups.

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“…According to American Brachytherapy Society recommendation for uveal melanoma the prescription treatment time is 3 to 7 consecutive days to deliver a total prescription dose. The prescription dose depends on the prescription point, method of dose prescription and dosimetry calculation assumption but following the Collaborative Ocular Melanoma Study (COMS) group dosimetry calculation assumption, is 85 Gray to the tumor apex (Nag et al, 2003;Baltimore 1995;Melia et al, 2001;Granero et al, 2010). In fact Monte Carlo Calculated dose rate for the eye plaque at interested point in the eye region has helped design of eye plaque as a valuable brachytherapy dosimetry tool.…”

Section: Other Application Of Monte Carlomentioning

confidence: 99%

Dosimetric Characteristics of the Brachytherapy Sources Based on Monte Carlo Method

Sadeghi¹,

Saidi²,

Tenreiro³

2011

Applications of Monte Carlo Methods in Biology, Medicine and Other Fields of Science

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The American Brachytherapy Society recommendations for brachytherapy of uveal melanomas

Cited by 222 publications

References 92 publications

Ruthenium-106 brachytherapy for thick uveal melanoma: reappraisal of apex and base dose radiation and dose rate

Ruthenium-106 brachytherapy for thick uveal melanoma: reappraisal of apex and base dose radiation and dose rate

Posterior uveal melanoma treated with I-125 brachytherapy or primary enucleation

Dosimetric Characteristics of the Brachytherapy Sources Based on Monte Carlo Method

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