scholarly journals Conjunctival Dehiscence and Scleral Necrosis following Iodine-125 Plaque Brachytherapy for Uveal Melanoma: A Report of 3 Cases

2018 ◽  
Vol 4 (5) ◽  
pp. 291-296 ◽  
Author(s):  
Duncan E. Berry ◽  
Dilraj S. Grewal ◽  
Prithvi Mruthyunjaya
Keyword(s):  
Uveal Melanoma ◽  
Iodine 125 ◽  
Plaque Brachytherapy

scholarly journals No Gender Differences in Long-Term Survival after Brachytherapy of 1,541 Patients with Uveal Melanoma

2019 ◽  
Vol 5 (6) ◽  
pp. 432-439 ◽  
Author(s):  
Gustav Stålhammar ◽  
Thonnie Rose See ◽  
Maria Filì ◽  
Stefan Seregard
Keyword(s):  
Uveal Melanoma ◽  
Therapeutic Interventions ◽  
Term Survival ◽  
Men And Women ◽  
Kaplan Meier ◽  
Iodine 125 ◽  
Gender Based ◽  
Survival Differences ◽  
Related Mortality ◽  
Plaque Brachytherapy

Background: In several malignancies, gender-based survival differences after specific therapeutic interventions have been demonstrated. It is not known whether such differences exist after plaque brachytherapy of uveal melanoma. Methods: All patients who received brachytherapy for uveal melanoma at St. Erik Eye Hospital from November 1, 1979 through November 20, 2017 were included (n = 1,541). Retrospective data were retrieved including baseline patient and tumor characteristics, brachytherapy nuclide (ruthenium-106 or iodine-125), radiation dose, treatment duration, tumor relapses, date of metastasis, and cause of death. Results: A total of 775 men and 766 women were treated with plaque brachytherapy. There were no significant differences between the genders in baseline characteristics, treatment, or follow-up. Men and women had similar rates of tumor relapses, hazard for repeated brachytherapy (men vs. women 0.8, p = 0.47), enucleation-free survival, and survival after detection of metastasis. Five-, 10-, and 15-year melanoma-related mortality was 14, 24, and 27% for men and 15, 26, and 32% for women, respectively. There were no significant differences in hazard for melanoma-related mortality (men vs. women 0.9, p = 0.32), median Kaplan-Meier disease-specific survival (men 18.2 years, women 15.5 years, p = 0.22), or median overall survival (men 13.5 years, women 12.6 years, p = 0.60). Conclusion: There are no relevant differences between men and women in ocular or patient survival after brachytherapy for uveal melanoma.

scholarly journals Regression patterns of uveal melanoma after iodine-125 plaque brachytherapy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rui Fang ◽  
Heng Wang ◽  
Yang Li ◽  
Yue-Ming Liu ◽  
Wen-Bin Wei
Keyword(s):  
Uveal Melanoma ◽  
Tumor Regression ◽  
Chi Square ◽  
Basal Diameter ◽  
Regression Rate ◽  
Chi Square Test ◽  
Iodine 125 ◽  
Plaque Brachytherapy ◽  
Uveal Melanomas

Abstract Background Tumor regression of uveal melanomas (UMs) after radiotherapy has been reported as a valuable prognostic factor for metastasis and metastatic death. But its effect on prognosis is questionable. The purpose of this study was to summarize the regression features of uveal melanoma after iodine-125 plaque brachytherapy and the relationship with prognosis. Methods Adult uveal melanoma patients who only received iodine-125 plaque brachytherapy between December 2009 and March 2018 at the Beijing Tongren Hospital, Capital Medical University were enrolled in this study. The regression rate was calculated as the percent change in tumor height, and each eye was classified for four main regression patterns: Decrease (D), Stable (S), Others (O), and Increase (I), according to the trend of height change. Statistical analysis was performed using one-way ANOVA and chi-square test, univariate and multivariate logistic regression, and Kaplan-Meier analysis. Results A total of 139 patients was included in the study. The median follow-up was 35 months. Regression patterns status was pattern D in 65 tumors (46.8%), pattern S in 50 tumors (36.0%), pattern O in 6 tumors (4.3%), and pattern I in 18 tumors (12.9%). Reductions of tumor mean height for each follow-up visit were 5.26% (3 months), 10.66% (6 months), 9.37% (12 months), and 14.68% (18 months). A comparison (D vs. S vs. O vs. I) revealed the preoperative height of pattern I was significantly lower than the pattern D, S and O (mean: 7.24 vs. 7.30 vs. 6.77 vs. 5.09 mm, respectively; P = 0.037). LBD (largest basal diameter) was strongly associated with the metastasis (P = 0.03). However, an association between the tumor regression and subsequent melanoma-related metastasis and mortality could not be confirmed (P = 0.66 and P = 0.27, respectively). The tumor regression rate increased with increasing tumor height (P = 0.04) and decreased with increasing of LBD (P = 0.01). Conclusion Our study showed a lack of association between the prognosis and the regression of uveal melanomas following I-125 plaque radiotherapy. The LBD and original height of the tumor have predictive value in tumor regression rate, and LBD was positively associated with metastasis.

scholarly journals Iodine-125 Episcleral Plaque Brachytherapy for AJCC T4 Posterior Uveal Melanoma: Clinical Outcomes in 158 Patients

2019 ◽  
Vol 5 (5) ◽  
pp. 340-349
Author(s):  
Benjamin A. King ◽  
Caroline Awh ◽  
Brad T. Gao ◽  
Jiajing Wang ◽  
Mehmet Kocak ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Treatment Failure ◽  
Uveal Melanoma ◽  
Cumulative Incidence ◽  
Vitreous Hemorrhage ◽  
Patient Age ◽  
Ocular Morbidity ◽  
Iodine 125 ◽  
Baseline Visual Acuity ◽  
Plaque Brachytherapy

Background/Aims: The aim of this study is to report the burden of ocular morbidity following iodine-125 episcleral plaque brachytherapy (EPBT) in the treatment of American Joint Committee on Cancer (AJCC) T4-staged posterior uveal melanoma (PUM). Methods: Clinical records of patients with T4-staged PUM treated with 125I EPBT were analyzed for incidence of treatment failure and radiation-induced complications. Results: Cumulative incidence of local treatment failure was 9% (95% CI 5–15%) at 5 years and was associated with decreased tumor height (HR = 0.78; p = 0.01). Cumulative incidence of enucleation at 5 years was 21% and was correlated with worsening baseline visual acuity (HR = 1.42; p = 0.05). Increasing patient age was associated with higher rates of vitreous hemorrhage (HR = 1.03; p = 0.02) and cataract surgery (HR = 1.05; p < 0.001). Increased tumor height was associated with higher rates of neovascular glaucoma (HR = 1.16; p = 0.03) and vitreous hemorrhage (HR = 1.23; p < 0.001). Conclusion: 125I EPBT is an effective treatment for T4-staged PUM and achieves high rates of local control. Treatment failure appears to be more common among minimally elevated tumors. Other causes of ocular morbidity were associated with increasing tumor height, patient age, and baseline visual acuity.

A choice of radionuclide: Comparative outcomes and toxicity of ruthenium-106 and iodine-125 in the definitive treatment of uveal melanoma

2015 ◽  
Vol 5 (3) ◽  
pp. e169-e176 ◽  
Author(s):  
Vinita Takiar ◽  
K. Ranh Voong ◽  
Dan S. Gombos ◽  
Firas Mourtada ◽  
Laura A. Rechner ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Definitive Treatment ◽  
Iodine 125

Patterns of care and outcomes of proton and eye plaque brachytherapy for uveal melanoma: Review of the National Cancer Database

Brachytherapy ◽  
2017 ◽  
Vol 16 (6) ◽  
pp. 1225-1231 ◽  
Author(s):  
Alexander J. Lin ◽  
Yuan J. Rao ◽  
Sahaja Acharya ◽  
Julie Schwarz ◽  
Prabakar Kumar Rao ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Patterns Of Care ◽  
National Cancer Database ◽  
Eye Plaque ◽  
Plaque Brachytherapy

Incidence and Treatment of Toxicity following 125I Episcleral Plaque Brachytherapy for Uveal Melanoma

Brachytherapy ◽  
2013 ◽  
Vol 12 ◽  
pp. S19
Author(s):  
Shahed N. Badiyan ◽  
Rajesh C. Rao ◽  
Anthony J. Apicelli ◽  
Sahaja Acharya ◽  
Vivek Verma ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Plaque Brachytherapy

Glaucoma After Iodine-125 Brachytherapy for Uveal Melanoma

2020 ◽  
Vol 29 (1) ◽  
pp. 1-10
Author(s):  
Eun-Ah Kim ◽  
Diana Salazar ◽  
Colin A. McCannel ◽  
Mitchell Kamrava ◽  
David J. Demanes ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Iodine 125

Ruthenium-106 versus iodine-125 plaque brachytherapy of 571 choroidal melanomas with a thickness of ≥5.5 mm

2019 ◽  
Vol 104 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Maria Filì ◽  
Eric Trocme ◽  
Louise Bergman ◽  
Thonnie Rose Ong See ◽  
Helder André ◽  
...  
Keyword(s):  
Cox Regression ◽  
Patient Survival ◽  
Relative Survival ◽  
Kaplan Meier ◽  
Choroidal Melanomas ◽  
Iodine 125 ◽  
Size Controlled ◽  
Disease Specific ◽  
Related Mortality ◽  
Plaque Brachytherapy

BackgroundEpiscleral brachytherapy is the most common eye-preserving treatment for medium-sized choroidal melanomas. γ-emitting iodine-125 (125I) and β-emitting ruthenium-106 (106Ru) are widely used. The latter is however generally reserved for thinner tumours (<6 mm). In this study, we compare ocular and patient survival in thicker tumours treated with the respective radioisotope.MethodsAll patients with ≥5.5 mm thick choroidal melanomas who were treated with plaque brachytherapy at a single institution between 1 November 1979 and 31 December 2015 were included (n=571). Size-controlled Cox regression HRs for postbrachytherapy enucleation, repeated brachytherapy and melanoma-related mortality were calculated, as well as Kaplan-Meier disease-specific survival and relative 10-year survival in matched subgroups.Results317 patients were treated with 106Ru and 254 with 125I. The rate of repeated brachytherapy was significantly higher among patients treated with 106Ru (8%) than with 125I (1%, p<0.001). Size-controlled Cox regression HRs for postbrachytherapy enucleation (125I vs 106Ru 0.7, p=0.083) and melanoma-related mortality were not significant (125I vs 106Ru 1.1, p=0.63). Similarly, Kaplan-Meier disease-specific and relative 10-year survival was comparable in matched groups of 5.5–7.4 mm (relative survival 106Ru 59%, 125I 56%) and ≥7.5 mm thick tumours (relative survival 106Ru 46%, 125I 44%).ConclusionsRates of repeated brachytherapy were significantly higher among patients treated with 106Ru versus 125I for thick choroidal melanomas. There were, however, no significant differences in rates of enucleation or patient survival.

OCT changes in peri-tumour normal retina following ruthenium-106 and proton beam radiotherapy for uveal melanoma

2020 ◽  
pp. bjophthalmol-2019-314802
Author(s):  
Rumana Hussain ◽  
Florian Moritz Heussen ◽  
Heinrich Heimann
Keyword(s):  
Proton Beam ◽  
Uveal Melanoma ◽  
Choroidal Melanoma ◽  
Retinal Layer ◽  
Proton Beam Radiotherapy ◽  
Retinal Layers ◽  
Spectral Domain Oct ◽  
Ruthenium 106 Brachytherapy ◽  
Safety Margins ◽  
Plaque Brachytherapy

IntroductionUveal melanoma is most commonly treated with radiotherapy, destroying the tumour cells with adequate safety margins and limiting collateral damage to surrounding structures to preserve maximal vision. We used optical coherence tomography (OCT) to study the effects of radiotherapy on the retina.MethodsPatients with posteriorly located choroidal melanoma treated with proton beam radiotherapy (PBR) and ruthenium-106 brachytherapy between January 2010 and June 2014 underwent spectral domain OCT.ResultsImages of 32 patients following ruthenium-106 brachytherapy and 44 patients following proton beam teletherapy were analysed. Following plaque brachytherapy, an early marked disruption of the outer retinal layers could be observed in 30 cases (94%) with retinal atrophy evident in 26 cases (81%). In contrast, the images from patients who underwent PBR showed subtle outer retinal layer change with 16 cases (36%) showing some inner-outer segment junction disruption by 6 months and 63%  by 24 months with minimal atrophy. In cases with tumours <2 mm from the fovea, the visual loss was significantly less at 6 and 12 months in the proton beam group.ConclusionIn comparison to ruthenium-106 plaque brachytherapy, PBR leads to more subtle and slower changes in the outer retinal layers enabling retention of visual function for longer. The difference in dosing regime and dose distribution across the tumour is likely to be causative for this structural differential.

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