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Benjamin King, Henry Wynn, Bradley Gao, Vanessa Marie Morales, Matthew T Ballo, Matthew W Wilson; Repeat Episcleral Plaque Brachytherapy: Clinical Outcomes in Patients Treated for Locally Recurrent Choroidal Melanoma (CM). Invest. Ophthalmol. Vis. Sci. 2016;57(12):4094.
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© ARVO (1962-2015); The Authors (2016-present)
To report the primary measured outcomes of survival, local disease control, and vision in patients treated with repeat episcleral plaque brachytherapy (EPBT) for recurrent CM.
We searched our ocular oncology database to identify all patients treated with EPBT for CM who developed local recurrence.
We identified a total of 71 of 1201 patients treated with EPBT for CM between January 1985 and December 2012 who developed local recurrence. 27 patients (13 men) elected to be retreated with EPBT. Median age at initial diagnosis was 69 years. AJCC classifications of these patients’ primary tumors were: T2 (25 patients) and T3 (2 patients). Local recurrence was attributed to increase in height (n=14), in basal diameters (n=6), or both (n=7). Median follow-up time from initial treatment was 100 months. Median time to local recurrence was 43 months. Median follow-up time following the second plaque treatment was also 43 months. Five patients developed subsequent local recurrence, four of which were enucleated while one was treated with transpupillary thermotherapy (TTT). Two additional eyes were enucleated due to neovascular glaucoma. Kaplan-Meier estimate for local control at 5 years was 84.9%. Median logMAR visual acuity was 0.477 at time of recurrence and declined to 2.15 by the most recent follow-up exam. A total of 6 patients developed metastatic disease and 10 patients died (4 of them due to other co-morbidities). Kaplan-Meier estimate for absence of metastatic disease at five years was 78.9%.
Repeat plaque brachytherapy offers a viable alternative to enucleation in patients with local recurrence of CM yielding high rates of local control with predictable decline in visual acuity.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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