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D. Yu, M. Astrahan, J. I. Lim; Slotted Plaque in Brachytherapy of Medium-to-Large Malignant Uveal Melanomas. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5242.
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To report the use and outcomes of a novel 2 mm thick, slotted I125 episcleral plaque that collimates each I-125 seed individually resulting in more homogeneous dose to the tumor and underlying sclera and significantly reduced lateral radiation spread to uninvolved structures compared to other plaque designs.
Retrospective chart review of tumor characteristics, imaging studies and visual outcomes after slotted plaque treatment.
Seven eyes of seven patients diagnosed with larger medium (height greater than 6 mm) and large choroidal melanomas (height > 8 mm)) were treated with the slotted plaque between 1998 and 2006. Patients ranged in age from 24 to 89 years old (median 63 years). Eighty-five Gy was delivered to the apex of each tumor, and the plaque was removed on average at seven days. Length of follow-up ranged from 30 to 66 months (median 49 months). Median tumor size decreased from 7.50 mm (6.20 to 9.10 mm) pre-operatively to 3.06 mm (1.65 to 7.80 mm) at the last visit. Median visual acuity was 20/50 (20/25 to CF at 2ft) on presentation, and was CF at 2 ft (20/100 to HM) at the last follow up. One eye developed tumor recurrence. One successfully treated choroidal tumor patient developed a lung metastasis at five-years follow-up. There were no deaths at four-years follow-up.
The large choroidal tumors were successfully treated with the episcleral slotted plaque. The local recurrence and metastasis rates (14.3% in an average of 3 years) were relatively low in these patients with large choroidal melanomas.
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