Brachytherapy · 2025
Low dose iodine-125 brachytherapy and transpupillary thermal therapy for small- to medium-sized choroidal melanoma.
СтатьяНазвание и аннотация: Перевод в очереди
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Fattahi S, Deufel C L, Astafurov K V, Olsen T W, Stafford S L, Neben Wittich M A, Harmsen W S, Viehman J K, Dalvin L A, Petersen I A, Corbin K S
Аннотация
PURPOSE: COMS established iodine-125 (125I) brachytherapy as standard of care for medium-sized choroidal melanomas. However, there remains a gap in the literature regarding reduced dosing for medium-sized choroidal melanomas and standard dosing for small-sized choroidal melanomas. We explored the impact of reduced dose 125I brachytherapy on local tumor control and ocular adverse events (AEs).
METHODS: Patients diagnosed 2005-2019 with choroidal melanoma <5 mm thick and managed with 125I brachytherapy dose of 65 Gy to depth of 5 mm were included. Dose metrics were calculated using Monte Carlo-based dosimetry. Kaplan-Meier method was used to estimate overall survival and radiation-related AEs. Distant metastasis and local recurrence were reported using cumulative incidence with death as a competing risk. Univariate and multivariate associations were analyzed using Cox proportional hazards regression.
RESULTS: 143 patients met inclusion criteria with median follow-up of 7 years. Five-year Kaplan-Meier estimates of ocular AEs were 59.6% radiation maculopathy, 42.0% cystoid macular edema, 55.2% nonproliferative radiation retinopathy, 10.8% proliferative radiation retinopathy, and 35.6% radiation papillopathy. Five-year cumulative incidence of local recurrence was 0%, 5-year cumulative incidence of distant metastasis was 6.1%, and 5-year Kaplan-Meier estimate of overall survival was 96.5%.
CONCLUSION: Reduced dose 125I brachytherapy is feasible with excellent local tumor control.
METHODS: Patients diagnosed 2005-2019 with choroidal melanoma <5 mm thick and managed with 125I brachytherapy dose of 65 Gy to depth of 5 mm were included. Dose metrics were calculated using Monte Carlo-based dosimetry. Kaplan-Meier method was used to estimate overall survival and radiation-related AEs. Distant metastasis and local recurrence were reported using cumulative incidence with death as a competing risk. Univariate and multivariate associations were analyzed using Cox proportional hazards regression.
RESULTS: 143 patients met inclusion criteria with median follow-up of 7 years. Five-year Kaplan-Meier estimates of ocular AEs were 59.6% radiation maculopathy, 42.0% cystoid macular edema, 55.2% nonproliferative radiation retinopathy, 10.8% proliferative radiation retinopathy, and 35.6% radiation papillopathy. Five-year cumulative incidence of local recurrence was 0%, 5-year cumulative incidence of distant metastasis was 6.1%, and 5-year Kaplan-Meier estimate of overall survival was 96.5%.
CONCLUSION: Reduced dose 125I brachytherapy is feasible with excellent local tumor control.