June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Plaque Radiation Therapy for Large and Extra-large Choroidal Melanoma
Author Affiliations & Notes
  • Ekaterina Semenova
    Ocular Oncology, The New York Eye Cancer Center, New York, NY
    Ocular Oncology, The New York Eye and Ear Infirmary, New York, NY
  • Paul Finger
    Ocular Oncology, The New York Eye Cancer Center, New York, NY
    Ocular Oncology, The New York Eye and Ear Infirmary, New York, NY
  • Footnotes
    Commercial Relationships Ekaterina Semenova, The Eye Cancer Foundation (F); Paul Finger, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4235. doi:https://doi.org/
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    • Get Citation

      Ekaterina Semenova, Paul Finger; Plaque Radiation Therapy for Large and Extra-large Choroidal Melanoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4235. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To evaluate outcomes (vision, local control, complications) after ophthalmic plaque radiation therapy for large uveal melanomas.

Methods: We evaluated the results of ophthalmic plaque brachytherapy of 48 patients with American Joint Committee on Cancer (AJCC) T3 and T4 uveal melanomas treated within the period of 2002-2012 (with a minimum follow up of 6 months). Pretreatment comparative dosimetry studies resulted in the use of palladium-103 (n=47) or iodine-125 seed (n=1) sources. The mean dose to the tumor apex was 69 Gy (range 49-87Gy).

Results: Plaque radiotherapy provided local tumor control in 91.7% and eye retention in 89.6% of patients at a mean 4 years observation (range 6 to 125 months). The most common long-term brachytherapy-related complications were radiation retinopathy (66.7%) and radiation optic neuropathy (47.9%) developing 5 to 36 months after brachytherapy (mean 19 months). These complications were typically stabilized by periodic bevacizumab or ranibizumab intravitreal injections. Secondary cataract developed in 36.4% phakic eyes within 2-45 months after irradiation (mean 26 months). Pre-existing and persistent exudative retinal detachments were observed in 29.2% and were the major cause of vision loss. Iris neovascularization developed in 18.8% of the patients and secondary glaucoma in 16.6% requiring enucleation in 3 patients (6.3%). In this series 54.2% patients maintained 20/200 or better vision. Metastasis developed in 31.3% of patients.

Conclusions: In this series, palladium-103 plaque radiotherapy offered superior local control, visual acuity and eye retention rates as compared to those reported in the literature.

Keywords: 589 melanoma • 671 radiation therapy • 754 visual acuity  
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