Benjamin A King1,2, Caroline Awh1, Brad T Gao1, Jiajing Wang3, Mehmet Kocak3, Vanessa M Morales-Tirado1,4, Matthew T Ballo5, Matthew W Wilson1,2. 1. Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA. 2. Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA. 3. Department of Preventive Medicine, Division of Biostatistics and Epidemiology, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA. 4. Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA. 5. Department of Radiation Oncology, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA.
Abstract
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.
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.
Entities:
Keywords:
Brachytherapy; Local control; Prognostic factor; Uveal melanoma
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: Neil Chevli; Raed J Zuhour; Jay A Messer; Waqar Haque; Amy C Schefler; Eric H Bernicker; Patricia Chevez-Barrios; Andrew M Farach; E Brian Butler; Bin S Teh Journal: J Contemp Brachytherapy Date: 2022-04-02