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P. T. Finger, S. Krishna, K. Chin, G. Duvall; Palladium-103 Plaque Brachytherapy for Uveal Melanoma: 17 Years Experience. Invest. Ophthalmol. Vis. Sci. 2008;49(13):42.
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To evaluate the long term safety and efficacy of palladium-103 plaque radiation therapy for uveal melanoma.
A retrospective review of the results of 384 consecutively treated patients was performed. Each was treated over 5-7 continuous days, to a mean apex dose of 71 Gy. They were evaluated for tumor and patient specific characteristics as well as local control, visual acuity and eye retention.
There were 233 tumors posterior to the equator, 27 equatorial and 122 anterior melanomas. By AJCC-UICC classification there were 69-T1, 293-T2, 17-T3 and 4-T4 melanomas. In 1990, we treated the first patient with palladium-103 ophthalmic plaque radiation therapy for choroidal melanoma. Now, 17-years later, the maximum follow-up is 205 months (mean, 47 months). There have been 13 incidents of tumor regrowth for a 97% local radiation control rate. Only 3% have required secondary enucleation. Best corrected visual acuities are 20/200 or better in 76% (291/384). This may be due (in part) to laser and bevacizumab treatment to prevent and/or treat radiation optic neuropathy and maculopathy.
At The New York Eye Cancer Center, palladium-103 ophthalmic plaque brachytherapy has provided local control and eye retention rates equivalent to or superior than published alternative radiation methods. Our visual acuity outcomes are markedly superior (Table).
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