Pattern of Local Recurrence After I-125 Episcleral Brachytherapy for Uveal Melanoma in a Spanish Referral Ocular Oncology Unit
| Autor: | Pilar Alonso-Martínez, Ma Fe Muñoz-Moreno, Sara Sánchez-Tabernero, C. García-Álvarez, F. Lopez-Lara, Patricia Diezhandino, Jesús María de Frutos-Baraja, Maria A. Saornil |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Uveal Neoplasms medicine.medical_specialty Time Factors Visual acuity medicine.medical_treatment Brachytherapy Visual Acuity Uveal Neoplasm Kaplan-Meier Estimate Medical Oncology Eye Enucleation Metastasis Iodine Radioisotopes 03 medical and health sciences 0302 clinical medicine medicine Humans Prospective Studies Treatment Failure Prospective cohort study Melanoma Referral and Consultation Survival rate Aged business.industry Incidence Incidence (epidemiology) Middle Aged medicine.disease Surgery Survival Rate Ophthalmology Spain 030220 oncology & carcinogenesis 030221 ophthalmology & optometry Female Neoplasm Recurrence Local medicine.symptom business |
| Zdroj: | American Journal of Ophthalmology. 180:39-45 |
| ISSN: | 0002-9394 |
| DOI: | 10.1016/j.ajo.2017.05.019 |
| Popis: | Purpose To describe the time, frequency, and clinical characteristics of treatment failure after I-125 brachytherapy in patients with uveal melanoma treated and followed in a Spanish referral ocular oncology unit. Design Prospective, consecutive, interventional case series. Methods Patients diagnosed with uveal melanoma from 1995 to 2016 and treated with episcleral brachytherapy were included. Demographic data collection, ophthalmic evaluation, ultrasound scan, and systemic studies were performed at baseline, every 6 months thereafter for 5 years, and subsequently at annual intervals. Recurrence was defined as presence of tumor growth after treatment. Baseline analysis was performed by descriptive methods and survival by Kaplan-Meier curves. Results From 732 patients diagnosed with uveal melanoma, 311 were treated with brachytherapy. In the follow-up (mean 79 months, standard deviation = 55), 16 local tumor recurrences (5.1%) were detected. All relapsing patients had choroidal tumors and 15 presented with visual symptoms. All patients were treated with I-125 brachytherapy, and 2 received associated transpupillary thermotherapy. All the eyes were enucleated after recurrence. Kaplan-Meier analysis showed a mean time of recurrence of 3.7 years (standard deviation = 2.94 years, ranging from 1 to 12 years). Three patients had metastasis in the follow-up. Kaplan-Meier analysis showed worse survival for patients with recurrence. Conclusion Local treatment failure was a relatively infrequent event after I-125 brachytherapy in our series. Recurrences appear not only early but also late in the follow-up. They do not have a distinctive clinical pattern and are associated with poorer survival. |
| Databáze: | OpenAIRE |
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