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Review
. 2017 Sep;3(3):193-198.
doi: 10.1159/000455872. Epub 2017 Feb 8.

Iodine-125 Brachytherapy for Uveal Melanoma: A Systematic Review of Radiation Dose

Jose J Echegaray  1 , Nikolaos E Bechrakis  2 , Nakul Singh  3 , Claudine Bellerive  4 , Arun D Singh  4
Affiliations
Review

Iodine-125 Brachytherapy for Uveal Melanoma: A Systematic Review of Radiation Dose

Jose J Echegaray et al. Ocul Oncol Pathol. 2017 Sep.

Abstract

Aim: To investigate whether lower radiation doses may yield similar outcome measures to those from the COMS trial.

Methods: A literature review of English language articles was performed using the PubMed database of the U.S. National Library of Medicine and the Cochrane Central Register of Controlled Trials using the following keywords: uveal melanoma, choroidal melanoma, primary uveal malignant melanoma, iodine-125 brachytherapy, local recurrence, local treatment failure, and local tumor control. The relationships between study local recurrence rate and median dosage were tested by linear regression, with each study weighted by the number of patients included.

Results: Fifteen retrospective and prospective studies were selected for systematic review (2,662 patients). Ranges of reported mean or median radiation dose to tumor apex were 62.5-104.0 Gy. Local recurrence rates ranged from 0 to 24%. A 1.0-Gy increase in the average study dose was associated with a 0.14% decrease in local recurrence rate, which was not statistically significant (p value 0.336).

Conclusion: The gold standard empirically derived 85.0-Gy radiation dose for the treatment of uveal melanoma could be tested in a randomized study.

Keywords: Brachytherapy; COMS trial; Radiation dose; Uveal melanoma.

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Figures

Fig. 1
Fig. 1
Flow diagram of systematic review of literature and study selection.
Fig. 2
Fig. 2
Published studies. Association between median dose and control rate. The x axis shows radiation dose in Gy. Points represent the median dose reported in a study. The size of the point corresponds to the number of subjects in the study. The y axis is the reported local control rate of the study. The blue line represents the line of best fit, weighted by the number of subjects in the study. The grey areas represent the standard error associated with the line of best fit. Because the grey area includes a potentially horizontal line, we cannot exclude that there is no relationship between study median dose and control rate.
See this image and copyright information in PMC

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