R van Ginderdeuren1, E van Limbergen, W Spileers. 1. Department of Ophthalmology, Kapucijnenvoer 33, UZ Leuven, B3000 Leuven, Belgium. rita.vanginderdeuren@uz.kuleuven.ac.be
Abstract
AIM: To analyse local tumour control, radiation related complications, visual acuity, enucleation rate, and survival after brachytherapy of small to medium sized choroidal melanoma (CM) with a high dose rate (HDR) strontium-90 (Sr-90) applicator. METHODS: From 1983 until 2000, 98 eyes with CM were treated with Sr-90 brachytherapy. The main outcome measures were actuarial rates of the patients' survival, ocular conservation rate, tumour regression, complication rates, and preservation of visual acuity. End point rates were estimated using Kaplan-Meier analysis. RESULTS: The median follow up time was 6.7 years (0.5-18.8 years). Actuarial melanoma free patient survival rate was 85% (SE 4.8%) after 18 years. Actuarial rate of ocular conservation and complete tumour regression was 90% (SE 3.8%) after 15 years. In 93% local tumour control was achieved, 88% showed a stable scar. Recurrence of the tumour on the border caused enucleation of six eyes (7%). In three cases (4%) retinal detachment was the end point. No cases of optic atrophy or of sight impairing retinopathy outside the treated area were found. Actuarial rate of preservation of visual acuity of 1/10 was 65% at 5 years and 45% at 15 years of follow up (SE 5.9% and 8.8%). CONCLUSIONS: Sr-90 brachytherapy is as effective as iodine or ruthenium brachytherapy for small to medium sized CM but causes fewer complications. The preservation of vision is better than with all other described radioisotopes. HDR Sr-90 brachytherapy can therefore safely be recommended for small to medium sized CM.
AIM: To analyse local tumour control, radiation related complications, visual acuity, enucleation rate, and survival after brachytherapy of small to medium sized choroidal melanoma (CM) with a high dose rate (HDR) strontium-90 (Sr-90) applicator. METHODS: From 1983 until 2000, 98 eyes with CM were treated with Sr-90 brachytherapy. The main outcome measures were actuarial rates of the patients' survival, ocular conservation rate, tumour regression, complication rates, and preservation of visual acuity. End point rates were estimated using Kaplan-Meier analysis. RESULTS: The median follow up time was 6.7 years (0.5-18.8 years). Actuarial melanoma free patient survival rate was 85% (SE 4.8%) after 18 years. Actuarial rate of ocular conservation and complete tumour regression was 90% (SE 3.8%) after 15 years. In 93% local tumour control was achieved, 88% showed a stable scar. Recurrence of the tumour on the border caused enucleation of six eyes (7%). In three cases (4%) retinal detachment was the end point. No cases of optic atrophy or of sight impairing retinopathy outside the treated area were found. Actuarial rate of preservation of visual acuity of 1/10 was 65% at 5 years and 45% at 15 years of follow up (SE 5.9% and 8.8%). CONCLUSIONS:Sr-90 brachytherapy is as effective as iodine or ruthenium brachytherapy for small to medium sized CM but causes fewer complications. The preservation of vision is better than with all other described radioisotopes. HDR Sr-90 brachytherapy can therefore safely be recommended for small to medium sized CM.
Authors: Lee M Jampol; Claudia S Moy; Timothy G Murray; Sandra M Reynolds; Daniel M Albert; Andrew P Schachat; Kenneth R Diddie; Robert E Engstrom; Paul T Finger; Kenneth R Hovland; Leonard Joffe; Karl R Olsen; Craig G Wells Journal: Ophthalmology Date: 2002-12 Impact factor: 12.079
Authors: J Pe'er; F H Stefani; S Seregard; T Kivela; P Lommatzsch; J U Prause; B Sobottka; B Damato; I Chowers Journal: Br J Ophthalmol Date: 2001-10 Impact factor: 4.638
Authors: E Egger; A Schalenbourg; L Zografos; L Bercher; T Boehringer; L Chamot; G Goitein Journal: Int J Radiat Oncol Biol Phys Date: 2001-09-01 Impact factor: 7.038
Authors: Robert Jones; Elizabeth Gore; William Mieler; Kevin Murray; Michael Gillin; Katherine Albano; Beth Erickson Journal: Int J Radiat Oncol Biol Phys Date: 2002-03-15 Impact factor: 7.038