A comparison between<sup>125</sup>Iodine brachytherapy and stereotactic radiotherapy in the management of juxtapapillary choroidal melanoma

Krema, Hatem; Heydarian, M.; Beiki-Ardakani, Akbar; Weisbrod, Daniel J.; Xu, Wei; Simpson, E. Rand; Sahgal, Arjun

doi:10.1136/bjophthalmol-2012-302808

Cited by 29 publications

(24 citation statements)

References 34 publications

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“…While radiation papillopathy following plaque brachytherapy is less common than with other radiation modalities, such as stereotactic radiation [16], its incidence has been reported to vary between 22 and 77% at 5–10 years [3, 5]. The incidence of radiation papillopathy in our study was lower, both overall (5.5%) and within the subset of 40 patients with juxtapapillary tumors ≤1 mm from the optic nerve (10.0%).…”

Section: Discussioncontrasting

confidence: 47%

The Use of Intravitreal Anti-VEGF and Triamcinolone in the Treatment of Radiation Papillopathy

et al. 2018

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Background/Aims: To evaluate a treatment regimen for radiation papillopathy. Methods: This is a prospective noncomparative interventional case series of patients who developed radiation papillopathy after plaque brachytherapy for uveal melanoma. Treatment consisted of intravitreal bevacizumab (IVB) (1.25 mg in 0.05 mL) at the time of diagnosis, and 1 week later, intravitreal triamcinolone (IVK) (2.00 mg in 0.05 mL). One month later, patients again received both IVB and IVK. Patients were then switched to monotherapy with monthly IVB until the papillopathy resolved. Results: Eleven patients developed radiation papillopathy, with 9 receiving treatment. On multivariate analysis, total radiation dose to the optic nerve was the only significant predictor of papillopathy (p = 0.005). Four of nine patients presented with a significant decline in visual acuity (VA) at the time of diagnosis of papillopathy. In all 4, significant improvement was documented following treatment. Five patients did not present with a decrease in VA, and in this group, 80% remained stable with treatment. Conclusions: In this series, patients who had a precipitous drop in VA at the time of diagnosis of radiation papillopathy returned to baseline VA following this treatment algorithm. This protocol was effective at maintaining stability of VA in 80% of those who developed papillopathy but did not present with an acute drop in VA.

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Section: Discussioncontrasting

confidence: 47%

The Use of Intravitreal Anti-VEGF and Triamcinolone in the Treatment of Radiation Papillopathy

et al. 2018

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“…Stereotactic radiation therapy is also an option but would be difficult to deliver in the emergency situation when patients present with acute visual loss and also on account that metastases are usually multiple and also bilateral in half of cases. Stereotactic radiotherapy is also associated with significantly higher rates of orbital morbidity at 4 years, in a study of orbital melanoma (9). Response rates to orbital radiation treatment are high but overall survival is generally poor on account of systemic disease.…”

Section: Discussionmentioning

confidence: 99%

Visual Impairment Due to Bilateral Multifocal Choroidal Metastasis of Parotid Adenocarcinoma: A Case Report

2014

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Background: Orbital metastases are an uncommon finding, being present in just 9% deceased patients with metastatic cancer. Only a quarter of patients with choroidal metastases have bilateral disease. Parotid cancer is not a common form of head and neck malignancy. Bilateral multifocal metastases from adenocarcinoma ex pleomorphic of parotid gland have been documented just once before in the literature. We present a similar case where palliative EBRT was used to gain local control with minimal toxicity.Case Presentation: The case of a 45-year-old Caucasian gentleman who presented to his general practitioner with otalgia and weight loss. Imaging revealed a mass in the deep lobe of the left parotid gland, invading into the medial pterygoid muscle. PET–CT revealed locoregional and distant lymphatic involvement plus disseminated skeletal metastases. Lymph node examination revealed adenocarcinoma ex pleomorphic histology. Within weeks of this diagnosis, the patient developed rapidly progressive visual impairment. Ophthalmologists found multifocal uveal masses bilaterally. Palliative fractions of external beam radiotherapy were delivered to the orbits before combination chemotherapy. We discuss the patient’s presentation, histopathology, and management, with support from the literature regarding applied and related therapies.Summary: In this rare presentation of disseminated malignancy affecting the choroid bilaterally, the authors demonstrate the application of palliative EBRT to good local effect. Given the nature of this treatment and that of the metastases, in the setting of incurable disease orbital morbidity is likely to occur again before the patient’s death. Awareness of the initial symptoms is important to provide prompt care and maintain quality of life.

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“…Hem verilen doz ile PTV yeterince kapsanamadığından hem de plak yerleştirilirken anatomik olarak optik sinir ve optik diskte harabiyete neden olduğundan, genellikle jukstapapiller yerleşimli lezyonlarda plak brakiterapi tercih edilmemektedir. 69 Jukstapapiller yerleşimli 30 olguya İyot-125 plak brakiterapi ve 64 olguya LINAK FSRT uygulanmıştır. 69,70 Ortanca takip süresi 46 ay olup, LK, GKO ve MsS oranı iki kol arasında benzer olduğu görülmüştür.…”

Section: Stereotaktik Radyoterapi Ile Uveal Melanom Tedavisi: Genel Sunclassified

“…69 Jukstapapiller yerleşimli 30 olguya İyot-125 plak brakiterapi ve 64 olguya LINAK FSRT uygulanmıştır. 69,70 Ortanca takip süresi 46 ay olup, LK, GKO ve MsS oranı iki kol arasında benzer olduğu görülmüştür. Komplikasyon oranları plak brakiterapi kolunda istatistiksel olarak anlamlı daha düşük bulunmuştur.…”

Section: Stereotaktik Radyoterapi Ile Uveal Melanom Tedavisi: Genel Sunclassified

“…45,53 Jukstapapiller yerleşimli tümörlerde plak brakiterapi ve LINAK FSRT'nin karşılaştırıldığı 94 olguyu içeren çalışmada komplikasyon oranları plak brakiterapi kolunda daha düşük bulunmuştur. 69,70 Sırasıyla, 50 aylık katarakt oranı plak brakiterapi kolunda %62, FSRT kolunda %75; neovasküler glokom %8'e %47; retinopati %59'a %89; papillopati %39'a %74 bulunmuştur.…”

Section: Radyoterapi Ile Uveal Melanom Tedavisi: Görme Keskinliğinin unclassified

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Uveal Malign Melanomlarda Stereotaktik Radyoterapi

Soykut¹,

Dizman²,

Güney³

2014

tjo

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Uveal melanom, erişkinlerde en sık görülen primer malign intraoküler neoplazmdır. Uveal melanom tedavisinin amacı, hastalığın metastatik yayılımını önleyebilmek ve mümkün olabildiğince hastanın görme fonksiyonunu etkin bir biçimde koruyabilmektir. Yirminci yüzyıl ortalarına kadar enükleasyon uveal melanom tedavisinde geleneksel yöntemken, gözün cerrahi olarak uzaklaştırılmasının sağkalım üzerine etkisi net değildir. Günümüzde radyoterapi uygulamaları tedavi tercihi olarak enükleasyonun yerini almıştır. Episkleral plak radyoterapi ve yüklü parçacık radyoterapi en çok çalışılmış yöntemlerdir. Son zamanlarda, stereotaktik radyoterapi yeni uygulanmaya başlanmış olup henüz uzun süreli data mevcut değildir.

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A comparison between¹²⁵Iodine brachytherapy and stereotactic radiotherapy in the management of juxtapapillary choroidal melanoma

Abstract: Both (125)Iodine brachytherapy and stereotactic radiotherapy demonstrate comparable efficacy in the management of juxtapapillary choroidal melanoma. However, stereotactic radiotherapy shows statistically significant higher radiation-induced ocular morbidities at 4 years postradiotherapy.

Cited by 29 publications

References 34 publications

The Use of Intravitreal Anti-VEGF and Triamcinolone in the Treatment of Radiation Papillopathy

The Use of Intravitreal Anti-VEGF and Triamcinolone in the Treatment of Radiation Papillopathy

Visual Impairment Due to Bilateral Multifocal Choroidal Metastasis of Parotid Adenocarcinoma: A Case Report

Uveal Malign Melanomlarda Stereotaktik Radyoterapi

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A comparison between125Iodine brachytherapy and stereotactic radiotherapy in the management of juxtapapillary choroidal melanoma

Abstract: Both (125)Iodine brachytherapy and stereotactic radiotherapy demonstrate comparable efficacy in the management of juxtapapillary choroidal melanoma. However, stereotactic radiotherapy shows statistically significant higher radiation-induced ocular morbidities at 4 years postradiotherapy.

Cited by 29 publications

References 34 publications

The Use of Intravitreal Anti-VEGF and Triamcinolone in the Treatment of Radiation Papillopathy

The Use of Intravitreal Anti-VEGF and Triamcinolone in the Treatment of Radiation Papillopathy

Visual Impairment Due to Bilateral Multifocal Choroidal Metastasis of Parotid Adenocarcinoma: A Case Report

Uveal Malign Melanomlarda Stereotaktik Radyoterapi

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A comparison between¹²⁵Iodine brachytherapy and stereotactic radiotherapy in the management of juxtapapillary choroidal melanoma