Transpupillary thermotherapy of choroidal melanoma with or without brachytherapy: a dilemma

Keunen, J. E. E.; Korver, J. G. Journée-de; Oosterhuis, J. A.

doi:10.1136/bjo.83.11.1212

Cited by 23 publications

(6 citation statements)

References 4 publications

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“…TTT is currently combined with plaque radiotherapy [ 51 ] or is applied as secondary treatment to local tumour recurrence after radiotherapy or local resection [ 52 ].…”

Section: Treatmentmentioning

confidence: 99%

Uveal Melanoma

Papastefanou

Cohen

2011

Journal of Skin Cancer

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Uveal melanoma is the most common primary intraocular malignancy and the leading primary intraocular disease which can be fatal in adults. In this paper epidemiologic, pathogenetic, and clinical aspects of uveal melanoma are discussed. Despite the advance in local ocular treatments, there has been no change in patient survival for three decades. Development of metastases affects prognosis significantly. Current survival rates, factors predictive of metastatic potential and metastatic screening algorithms are discussed. Proposed and emerging treatments for uveal melanoma metastases are also overviewed. Current advances in genetics and cytogenetics have provided a significant insight in tumours with high metastatic potential and the molecular mechanisms that underlie their development. Biopsy of those lesions may prove to be important for prognostication and to allow further research into genetic mutations and potential new therapeutic targets in the future.

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“…TTT is currently combined with plaque radiotherapy [ 51 ] or is applied as secondary treatment to local tumour recurrence after radiotherapy or local resection [ 52 ].…”

Section: Treatmentmentioning

confidence: 99%

Uveal Melanoma

Papastefanou

Cohen

2011

Journal of Skin Cancer

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“…3e5, 10,11 These findings resulted in a split in the attitude of ocular oncologists toward the role of primary TTT for management of small choroidal melanoma. 12 Some, citing unacceptably high rates of local tumor recurrence and instances of extraocular tumor recurrence, have questioned primary TTT as an acceptable treatment for the management of small choroidal melanomas. 6,10,13,14 Other investigators are of the opinion that primary TTT of properly selected small choroidal melanomas can result in high rates of tumor control with acceptable rates of visual loss.…”

mentioning

confidence: 99%

Primary Transpupillary Thermotherapy for Choroidal Melanoma in 391 Cases

et al. 2015

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“…3 Combined therapy makes it possible to treat patients with tumours thicker than 5 mm, which is generally considered the maximum thickness for ruthenium-106 ( 106 Ru) plaque radiotherapy. 2 6 Combined treatment may also reduce the risk of insufficient treatment of scleral melanoma cells after primary TTT, 8 and may make it possible to use a lower dose of radiation in plaque radiotherapy.…”

mentioning

confidence: 99%

Combined plaque radiotherapy and transpupillary thermotherapy in choroidal melanoma: 5 years' experience

Bartlema

Oosterhuis²,

Korver³

et al. 2003

British Journal of Ophthalmology

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Aim: To evaluate the results of combined plaque radiotherapy and transpupillary thermotherapy (TTT) in 50 consecutive patients 5 years after treatment. Methods: 50 adult patients with choroidal melanoma were treated with ruthenium-106 ( 106 Ru) plaque radiotherapy combined with TTT. A flat scar was the preferred end point of treatment. The mean tumour thickness was 3.9 mm (range 1.5-8.0 mm), the mean tumour diameter was 11.3 mm (range 5.8-15.0 mm). TTT was performed with an infrared diode laser at 810 nm, a beam diameter of 2-3 mm, and 1 minute exposures. Tumours .5 mm thick received an episcleral contact dose of 800 Gy 106 Ru; tumours (5 mm thick received a contact dose of 600 Gy 106 Ru. TTT was repeated in case of incomplete tumour regression after combined therapy. Results: Complete tumour regression was obtained in 45 patients. It required one, two, or three TTT sessions in 32, 11, and two patients, respectively. In tumours (3 mm thick complete flattening was achieved significantly faster than in tumours .3 mm thick (log rank test p = 0.01). Eight melanomas were amelanotic, seven of which required multiple TTT sessions. In one patient the tumour recurred at the central margin of the treated area; this eye was enucleated. In one patient the tumour failed to regress 6 months after treatment and enucleation was performed at the patient's request. Three eyes developed severe proliferative retinopathy. Radiation maculopathy caused a loss of the best corrected visual acuity: before treatment 31 patients had a best corrected visual acuity of 20/60 or better but in only 12 patients did it remain in this range 5 years after treatment. Three patients developed distant metastasis to the liver. Conclusion: The 5 year results for combined plaque radiotherapy and TTT as treatment for choroidal melanoma are favourable in terms of complete tumour regression and low rate of recurrences; however, there was considerable loss of visual acuity as a result of radiation maculopathy.

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Transpupillary thermotherapy of choroidal melanoma with or without brachytherapy: a dilemma

Cited by 23 publications

References 4 publications

Uveal Melanoma

Uveal Melanoma

Primary Transpupillary Thermotherapy for Choroidal Melanoma in 391 Cases

Combined plaque radiotherapy and transpupillary thermotherapy in choroidal melanoma: 5 years' experience

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