PURPOSE: To determine the outcome of 125I plaque brachytherapy at our institution and identify the risk factors associated with the development of radiation complications, tumor recurrence, and metastasis. PATIENTS AND METHODS: From 1986 to 2000, 156 patients underwent 125I episcleral plaque (COMS design) application for the treatment of ocular melanoma. Chart analysis of follow-up ophthalmologic appointments assessed the incidence of ocular side effects after therapy. Statistical analysis assessed outcomes and significant influencing factors. RESULTS: With a median follow-up of 6.2 years, the 5-year overall survival was 83%. The 5-year disease-specific survival was 91%. Initial local control at 5 years was 92%, with 100% ultimate local control after secondary therapy that included 9 enucleations. The risk of metastasis was 10% at 5 years and 27% at 10 years. Vision stayed the same or improved in 25% of patients, and 44% of patients maintained visual acuity better than 20/200. Thirteen percent of patients experienced chronic pain or discomfort in the treated eye. Dose rates to the tumor apex greater than 90 to 100 cGy/h were associated with increased systemic control but worse radiation toxicity. CONCLUSION: Patients in our series experienced excellent local tumor control. Higher dose rates to the tumor apex were associated with reduced rates of distant metastases but worse ocular function.
PURPOSE: To determine the outcome of 125I plaque brachytherapy at our institution and identify the risk factors associated with the development of radiation complications, tumor recurrence, and metastasis. PATIENTS AND METHODS: From 1986 to 2000, 156 patients underwent 125I episcleral plaque (COMS design) application for the treatment of ocular melanoma. Chart analysis of follow-up ophthalmologic appointments assessed the incidence of ocular side effects after therapy. Statistical analysis assessed outcomes and significant influencing factors. RESULTS: With a median follow-up of 6.2 years, the 5-year overall survival was 83%. The 5-year disease-specific survival was 91%. Initial local control at 5 years was 92%, with 100% ultimate local control after secondary therapy that included 9 enucleations. The risk of metastasis was 10% at 5 years and 27% at 10 years. Vision stayed the same or improved in 25% of patients, and 44% of patients maintained visual acuity better than 20/200. Thirteen percent of patients experienced chronic pain or discomfort in the treated eye. Dose rates to the tumor apex greater than 90 to 100 cGy/h were associated with increased systemic control but worse radiationtoxicity. CONCLUSION:Patients in our series experienced excellent local tumor control. Higher dose rates to the tumor apex were associated with reduced rates of distant metastases but worse ocular function.
Authors: Jasmina Ziva Cerne; Sean Michael Hartig; Mark Patrick Hamilton; Sue Anne Chew; Nicholas Mitsiades; Vassiliki Poulaki; Sean Eric McGuire Journal: Invest Ophthalmol Vis Sci Date: 2014-04-07 Impact factor: 4.799
Authors: Mariam el Filali; Long V Ly; Gregorius P M Luyten; Mieke Versluis; Hans E Grossniklaus; Pieter A van der Velden; Martine J Jager Journal: Mol Vis Date: 2012-10-05 Impact factor: 2.367
Authors: Robert L Foote; Scott L Stafford; Ivy A Petersen; Jose S Pulido; Michelle J Clarke; Steven E Schild; Yolanda I Garces; Kenneth R Olivier; Robert C Miller; Michael G Haddock; Elizabeth Yan; Nadia N Laack; Carola A S Arndt; Steven J Buskirk; Vickie L Miller; Christopher R Brent; Jon J Kruse; Gary A Ezzell; Michael G Herman; Leonard L Gunderson; Charles Erlichman; Robert B Diasio Journal: Radiat Oncol Date: 2012-10-22 Impact factor: 3.481