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. 2018 Dec;10(6):532-541.
doi: 10.5114/jcb.2018.79886. Epub 2018 Dec 28.

Outcomes of I-125 brachytherapy for uveal melanomas depending on irradiation dose applied to the tumor apex - a single institution study

Joanna Kowal  1   2 , Anna Markiewicz  1   2 , Magdalena Dębicka-Kumela  1   2 , Anna Bogdali  1   2 , Boz Ena Romanowska-Dixon  1   2
Affiliations

Outcomes of I-125 brachytherapy for uveal melanomas depending on irradiation dose applied to the tumor apex - a single institution study

Joanna Kowal et al. J Contemp Brachytherapy. 2018 Dec.

Abstract

Purpose: The aim of the study was an evaluation of I-125 brachytherapy patients with uveal melanoma with special consideration for the relationship of the treatment results and the irradiation dose applied to the tumor apex.

Material and methods: Medical records of 344 adults with uveal melanoma treated with I-125 brachytherapy in the Department of Ophthalmology and Ocular Oncology of the Jagiellonian University, Medical College in Cracow, Poland were retrospectively analyzed. The study was conducted between 2003 and 2012, and the study group was divided into two subgroups depending on the irradiation dose applied to the top of the tumor: 80 Gy to 100 Gy (n = 177) and 100 Gy to 120 Gy (n = 167).

Results: It was found that the height of the tumor and the largest diameter of the tumor base decreased with every consecutive follow-up measurement and differed significantly in all comparisons (p < 0.0001). No significant correlation between frequency of complications was found between both study groups (χ2 = 0.27; p = 0.6067). The correlation between survival and the irradiation dose as applied to the tumor top was statistically irrelevant (χ2 = 0.44; p = 0.5084). A logistic regression model showed that patient survival depended on the largest diameter of the base and the height of tumor (p = 0.0216), and the risk of death was larger as these dimensions increased (IR, 1.17). An increase of the largest diameter of the base by 1 mm meant a 17% increase in chances of death. In 13.4% of cases, an enucleation was necessary.

Conclusions: The treatment of choroidal melanomas with I-125 iodine isotope brachytherapy is an efficient and recommended method of treatment and in many cases, an alternative to the enucleation of an eyeball.

Keywords: I-125 brachytherapy; irradiation dose; ocular melanoma; uveal melanoma.

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Figures

Fig. 1
Fig. 1
Maximum tumor height without the wall measured in three time-points: for the patient groups with the irradiation dose applied to the tumor top from 80 to 100 Gy (A) and from above 100 to 120 Gy (B) (ANOVA FRIEDMAN RANK test; p < 0.0001)
Fig. 2
Fig. 2
The largest size of the tumor base measured in three time points for the groups of patients from 80 to 100 Gy (A) and from above 100 Gy to 120 Gy (B) (ANOVA FRIEDMAN RANK test; p < 0.0001)
Fig. 3
Fig. 3
The choroidal melanoma regression after I-125 brachytherapy: before (A), after 1 year (B), and after 7 years (C) of treatment
See this image and copyright information in PMC

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