Kirtesh R Patel1, Roshan S Prabhu2, Jeffrey M Switchenko3, Mudit Chowdhary4, Caroline Craven5, Pia Mendoza5, Hasan Danish6, Hans E Grossniklaus5, Thomas M Aaberg5, Thomas Aaberg5, Sahitya Reddy5, Elizabeth Butker6, Chris Bergstrom5, Ian R Crocker6. 1. Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA. Electronic address: krpate8@emory.edu. 2. Southeast Radiation Oncology Group, Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC. 3. Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University, Atlanta, GA. 4. Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA; Department of Radiation Oncology, Rush University Medical Center, Chicago, IL. 5. Department of Ophthalmology and Winship Cancer Institute, Emory University, Atlanta, GA. 6. Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA.
Abstract
PURPOSE: To evaluate outcomes of choroidal melanoma patients treated with 125I or 103Pd plaque brachytherapy. METHODS AND MATERIALS: From 1993 to 2012, our institution treated 160 patients with 103Pd (56.1%) and 125 patients with 125I (43.9%) plaque brachytherapy. Tumor outcomes, visual acuity (VA), and toxicity were compared. Multivariate analyses (MVAs) and propensity score analysis were used to help address differences in baseline characteristics. RESULTS: Median followup was longer for 125I patients, 52.7 vs. 43.5 months (p < 0.01). At baseline, 103Pd patients had lower rates of VA worse than 20/200 (4.4% vs. 16%, p = 0.002), T3-T4 tumors (17.5% vs. 32.8%, p = 0.03), and transpupillary thermotherapy use (3.1% vs. 9.6%, p = 0.001). Both 103Pd and 125I provided >90% 3-year overall survival and >93% 5-year secondary enucleation-free survival. On MVA, radionuclide was not predictive for tumor outcomes. A higher percentage maintained vision better than 20/40 with 103Pd (63% vs. 35%, p = 0.007) at 3 years. MVA demonstrated 103Pd radionuclide (odds ratio [OR]: 2.12, p = 0.028) and tumor height ≤5 mm (OR: 2.78, p = 0.017) were associated with VA better than 20/40. Propensity score analysis matched 23 125I with 107 103Pd patients. 103Pd continued to predict better VA at 3 years (OR: 8.10, p = 0.014). On MVA for the development of VA worse than 20/200 or degree of vision loss, radionuclide was not significant. Lower rates of radiation retinopathy were seen with 103Pd than 125I (3 years: 47.3% vs. 63.9%, p = 0.016), with radionuclide significant in MVA. CONCLUSIONS: Both 125I and 103Pd achieve excellent tumor control. An increased probability of long-term VA better than 20/40 and reduced risk of radiation retinopathy is associated with 103Pd.
PURPOSE: To evaluate outcomes of choroidal melanomapatients treated with 125I or 103Pd plaque brachytherapy. METHODS AND MATERIALS: From 1993 to 2012, our institution treated 160 patients with 103Pd (56.1%) and 125 patients with 125I (43.9%) plaque brachytherapy. Tumor outcomes, visual acuity (VA), and toxicity were compared. Multivariate analyses (MVAs) and propensity score analysis were used to help address differences in baseline characteristics. RESULTS: Median followup was longer for 125I patients, 52.7 vs. 43.5 months (p < 0.01). At baseline, 103Pdpatients had lower rates of VA worse than 20/200 (4.4% vs. 16%, p = 0.002), T3-T4 tumors (17.5% vs. 32.8%, p = 0.03), and transpupillary thermotherapy use (3.1% vs. 9.6%, p = 0.001). Both 103Pd and 125I provided >90% 3-year overall survival and >93% 5-year secondary enucleation-free survival. On MVA, radionuclide was not predictive for tumor outcomes. A higher percentage maintained vision better than 20/40 with 103Pd (63% vs. 35%, p = 0.007) at 3 years. MVA demonstrated 103Pd radionuclide (odds ratio [OR]: 2.12, p = 0.028) and tumor height ≤5 mm (OR: 2.78, p = 0.017) were associated with VA better than 20/40. Propensity score analysis matched 23 125I with 107 103Pdpatients. 103Pd continued to predict better VA at 3 years (OR: 8.10, p = 0.014). On MVA for the development of VA worse than 20/200 or degree of vision loss, radionuclide was not significant. Lower rates of radiation retinopathy were seen with 103Pd than 125I (3 years: 47.3% vs. 63.9%, p = 0.016), with radionuclide significant in MVA. CONCLUSIONS: Both 125I and 103Pd achieve excellent tumor control. An increased probability of long-term VA better than 20/40 and reduced risk of radiation retinopathy is associated with 103Pd.
Authors: Rowan M Thomson; Keith M Furutani; Jose S Pulido; Scott L Stafford; D W O Rogers Journal: Int J Radiat Oncol Biol Phys Date: 2010-05-14 Impact factor: 7.038
Authors: Marie Diener-West; Sandra M Reynolds; Donna J Agugliaro; Robert Caldwell; Kristi Cumming; John D Earle; Barbara S Hawkins; James A Hayman; Ishmael Jaiyesimi; Lee M Jampol; John M Kirkwood; Wui-Jin Koh; Dennis M Robertson; John M Shaw; Bradley R Straatsma; Jonni Thoma Journal: Arch Ophthalmol Date: 2005-12
Authors: Sou-Tung Chiu-Tsao; Melvin A Astrahan; Paul T Finger; David S Followill; Ali S Meigooni; Christopher S Melhus; Firas Mourtada; Mary E Napolitano; Ravinder Nath; Mark J Rivard; D W O Rogers; Rowan M Thomson Journal: Med Phys Date: 2012-10 Impact factor: 4.071