Iodine-125 Episcleral Plaque Brachytherapy for AJCC T4 Posterior Uveal Melanoma: Clinical Outcomes in 158 Patients.

Autor:	King BA; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA.; Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Awh C; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA., Gao BT; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA., Wang J; Department of Preventive Medicine, Division of Biostatistics and Epidemiology, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA., Kocak M; Department of Preventive Medicine, Division of Biostatistics and Epidemiology, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA., Morales-Tirado VM; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA.; Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA., Ballo MT; Department of Radiation Oncology, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA., Wilson MW; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, Tennessee, USA.; Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Jazyk:	angličtina
Zdroj:	Ocular oncology and pathology [Ocul Oncol Pathol] 2019 Aug; Vol. 5 (5), pp. 340-349. Date of Electronic Publication: 2019 Jan 10.
DOI:	10.1159/000495249
Abstrakt:	Background/aims: The aim of this study is to report the burden of ocular morbidity following iodine-125 episcleral plaque brachytherapy (EPBT) in the treatment of American Joint Committee on Cancer (AJCC) T4-staged posterior uveal melanoma (PUM). Methods: Clinical records of patients with T4-staged PUM treated with 125 I EPBT were analyzed for incidence of treatment failure and radiation-induced complications. Results: Cumulative incidence of local treatment failure was 9% (95% CI 5-15%) at 5 years and was associated with decreased tumor height (HR = 0.78; p = 0.01). Cumulative incidence of enucleation at 5 years was 21% and was correlated with worsening baseline visual acuity (HR = 1.42; p = 0.05). Increasing patient age was associated with higher rates of vitreous hemorrhage (HR = 1.03; p = 0.02) and cataract surgery (HR = 1.05; p < 0.001). Increased tumor height was associated with higher rates of neovascular glaucoma (HR = 1.16; p = 0.03) and vitreous hemorrhage (HR = 1.23; p < 0.001). Conclusion: 125 I EPBT is an effective treatment for T4-staged PUM and achieves high rates of local control. Treatment failure appears to be more common among minimally elevated tumors. Other causes of ocular morbidity were associated with increasing tumor height, patient age, and baseline visual acuity. Competing Interests: We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial or proprietary support for this work that could have influenced its outcome.
Databáze:	MEDLINE
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