Jose J Echegaray1, Nikolaos E Bechrakis2, Nakul Singh3, Claudine Bellerive4, Arun D Singh4. 1. Department of Ophthalmology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA. 2. Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria. 3. Department of Ophthalmic Oncology, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA. 4. Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Abstract
AIM: To investigate whether lower radiation doses may yield similar outcome measures to those from the COMS trial. METHODS: A literature review of English language articles was performed using the PubMed database of the U.S. National Library of Medicine and the Cochrane Central Register of Controlled Trials using the following keywords: uveal melanoma, choroidal melanoma, primary uveal malignant melanoma, iodine-125 brachytherapy, local recurrence, local treatment failure, and local tumor control. The relationships between study local recurrence rate and median dosage were tested by linear regression, with each study weighted by the number of patients included. RESULTS: Fifteen retrospective and prospective studies were selected for systematic review (2,662 patients). Ranges of reported mean or median radiation dose to tumor apex were 62.5-104.0 Gy. Local recurrence rates ranged from 0 to 24%. A 1.0-Gy increase in the average study dose was associated with a 0.14% decrease in local recurrence rate, which was not statistically significant (p value 0.336). CONCLUSION: The gold standard empirically derived 85.0-Gy radiation dose for the treatment of uveal melanoma could be tested in a randomized study.
AIM: To investigate whether lower radiation doses may yield similar outcome measures to those from the COMS trial. METHODS: A literature review of English language articles was performed using the PubMed database of the U.S. National Library of Medicine and the Cochrane Central Register of Controlled Trials using the following keywords: uveal melanoma, choroidal melanoma, primary uveal malignant melanoma, iodine-125 brachytherapy, local recurrence, local treatment failure, and local tumor control. The relationships between study local recurrence rate and median dosage were tested by linear regression, with each study weighted by the number of patients included. RESULTS: Fifteen retrospective and prospective studies were selected for systematic review (2,662 patients). Ranges of reported mean or median radiation dose to tumor apex were 62.5-104.0 Gy. Local recurrence rates ranged from 0 to 24%. A 1.0-Gy increase in the average study dose was associated with a 0.14% decrease in local recurrence rate, which was not statistically significant (p value 0.336). CONCLUSION: The gold standard empirically derived 85.0-Gy radiation dose for the treatment of uveal melanoma could be tested in a randomized study.
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