Ruthenium-106 plaque brachytherapy for thick posterior uveal melanomas

被引:36
作者
Kaiserman, N. [1 ]
Kaiserman, I. [2 ]
Hendler, K. [1 ]
Frenkel, S. [1 ]
Pe'er, J. [1 ]
机构
[1] Hadassah Hebrew Univ, Med Ctr, Dept Ophthalmol, IL-91120 Jerusalem, Israel
[2] Barzilai Govt Hosp, Dept Ophthalmol, Ashqelon, Israel
关键词
COLLABORATIVE OCULAR MELANOMA; INITIAL MORTALITY FINDINGS; COMS RANDOMIZED-TRIAL; CHOROIDAL MELANOMA; RUTHENIUM PLAQUE; IODINE-125; BRACHYTHERAPY; SURVIVAL; RADIOTHERAPY; EXPERIENCE;
D O I
10.1136/bjo.2009.157701
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Aims: Ruthenium-106 brachytherapy is an effective method for treating small to medium uveal melanomas. The purpose of this study was to examine its effectiveness and safety in the management of thick posterior uveal melanoma (apical height >= 8.0 mm) and to compare it with enucleation. Methods: 126 consecutive patients with thick uveal melanoma were included. 63 patients treated with Ruthenium-106 brachytherapy were compared with 63 patients treated with enucleation. The main outcome measures were visual acuity, eye retention, local recurrence, metastases, all-cause mortality and melanoma-related mortality. Results: Patients treated with brachytherapy were significantly younger and had significantly smaller tumours, compared with patients treated with enucleation. Tumour thickness in the brachytherapy group was 9.3 (SD 0.9) mm compared with 12.2 (1.9) mm in the enucleation group. The 5- and 10-year melanoma-related mortality was 20.5% and 46.2% for brachytherapy patients and 28.1% and 44.0% for enucleation patients (p = 0.6 and p = 0.9). When comparing 15 brachytherapy with 15 matched enucleation patients, the 5- year melanoma-related mortalities were similar, 28.6% and 33.3% respectively (p = 0.7). Complications associated with brachytherapy included tumour regrowth (n = 15), scleral melt (n = 3), neovascular glaucoma (n = 5) and vitreous haemorrhage (n = 3). In the brachytherapy group, no significant difference in survival was noted between patients who did and did not develop local recurrence (p = 0.9). Of the eyes that were initially treated with brachytherapy, 71.4% were saved from enucleation. Of these, 70.8% had a final visual acuity of 20/200 or better. Conclusions: Ruthenium-106 brachytherapy is an alternative to enucleation in some thick posterior uveal melanomas.
引用
收藏
页码:1167 / 1171
页数:5
相关论文
共 22 条
[1]  
Albert DM, 1998, AM J OPHTHALMOL, V125, P779
[2]   Histopathologic characteristics of choroidal melanoma in eyes enucleated after iodine 125 brachytherapy in the Collaborative Ocular Melanoma Study [J].
Avery, Robert B. ;
Diener-West, Marie ;
Reynolds, Sandra M. ;
Grossniklaus, Hans E. ;
Green, W. Richard ;
Albert, Daniel M. .
ARCHIVES OF OPHTHALMOLOGY, 2008, 126 (02) :207-212
[3]   Iodine 125 plaque brachytherapy versus transscleral tumor resection in the treatment of large uveal melanomas [J].
Bechrakis, NE ;
Bornfeld, N ;
Zöller, I ;
Foerster, MH .
OPHTHALMOLOGY, 2002, 109 (10) :1855-1861
[4]  
COX DR, 1972, J R STAT SOC B, V34, P187
[5]  
Diener-West M, 2001, ARCH OPHTHALMOL-CHIC, V119, P969
[6]   TREATMENT OF CHOROIDAL MELANOMA WITH I-125 PLAQUE [J].
FONTANESI, J ;
MEYER, D ;
XU, SZ ;
TAI, D .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1993, 26 (04) :619-623
[7]  
Hall E.J., 1994, Radiobiology for the Radiologist, P1
[8]   The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma - IV. Local treatment failure and enucleation in the first 5 years after brachytherapy. COMS report No. 19 [J].
Jampol, LM ;
Moy, CS ;
Murray, TG ;
Reynolds, SM ;
Albert, DM ;
Schachat, AP ;
Diddie, KR ;
Engstrom, RE ;
Finger, PT ;
Hovland, KR ;
Joffe, L ;
Olsen, KR ;
Wells, CG .
OPHTHALMOLOGY, 2002, 109 (12) :2197-2206
[9]   NONPARAMETRIC-ESTIMATION FROM INCOMPLETE OBSERVATIONS [J].
KAPLAN, EL ;
MEIER, P .
JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION, 1958, 53 (282) :457-481
[10]   RATES OF LOCAL-CONTROL, METASTASIS, AND OVERALL SURVIVAL IN PATIENTS WITH POSTERIOR UVEAL MELANOMAS TREATED WITH RU-106 PLAQUES [J].
KLEINEIDAM, M ;
GUTHOFF, R ;
BENTZEN, SM .
RADIOTHERAPY AND ONCOLOGY, 1993, 28 (02) :148-156