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Paul T Finger, ; The 2014 American Brachytherapy Society (ABS) Guidelines for Plaque Brachytherapy of Uveal Melanoma and Retinoblastoma. Invest. Ophthalmol. Vis. Sci. 2014;55(13):6021.
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To present the current, updated American Brachytherapy Society (ABS) concenus guidelines for plaque brachytherapy of choroidal melanoma and retinoblastoma to the community of eye care professionals.
An international, multicenter Ophthalmic Oncology Task Force (OOTF) was assembled to include 47 radiation oncologists, medical physicists and ophthalmic oncologists from 13 centers in 10 countries. Thus, the committee included specialists from Europe (Sweden, Finland, United Kingdom, Germany, France), Russia, Japan, India, The United States of America (New York, Tennessee, Georgia, Rhode Island) and Toronto- Ontario-Canada. Thus, the ABS-OOTF produced universally acceptable collaborative guidelines, based on their eye cancer specific clinical experience and knowledge of the literature. Further, these resultant guidelines were staged by levels of consensus. Once completed, this work was reviewed and approved by the 10 person American Brachytherapy Society Board of Directors as well as 4 external reviewers.
1) The ABS-OOTF reached consensus that ophthalmic plaque radiation therapy is best performed in subspecialty brachytherapy centers, experienced with plaque therapy. 2) Quality assurance, methods of plaque construction/dosimetry should be consistent with the 2012 joint guidelines of the American Association of Physicists in Medicine and ABS. 3) Though there exist select restrictions related to tumor-size, location and vision status; the ABS-OOTF agreed that most uveal melanomas (iris, ciliary body and choroid) could be treated with plaque brachytherapy. Specifically, the ABS-OOTF reached consensus that tumors with gross orbital extension, blind painful eyes and those with no light perception vision are unsuitable for brachytherapy. 4) Only select retinoblastomas were considered eligible for plaque brachytherapy. 5) Additional subjects addressed include prescription doses, dose rates, treatment durations and clinical methods.
Plaque brachytherapy is an effective, eye and vision-sparing method to treat patients with intraocular tumors. Eye cancer specialists (radiation oncologists, medical physicists and ophthalmic oncologists) are encouraged to use both the AAPM-ABS guidelines for plaque dosimetry and quality assurance as well as the ABS-OOTF clinical guidelines to enhance their practice.
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