Prescribing to tumor apex in episcleral plaque iodine-125 brachytherapy for medium-sized choroidal melanoma: A single-institutional retrospective review

Vonk, D.T.; Kim, Yongbok; Javid, Cameron; Gordon, John; Stea, Baldassarre

doi:10.1016/j.brachy.2015.05.002

Cited by 19 publications

(12 citation statements)

References 23 publications

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“…19 Other series utilizing 125 I episcleral brachytherapy showed similar or superior preservation of visual acuity over a longer followup period. 12,[20][21][22][23] Radiation maculopathy, radiation-induced optic neuropathy and/or retinopathy, exudative retinal detachment, vitreous hemorrhage, cataract, neovascular glaucoma and/or enucleation are the most frequently recognized mechanisms for visual loss in such patients. 12 In the current study after a 30-month follow-up, in 106 Ru group, 60% (n=12) of the patients reserved 20/200 vision or more.…”

Section: Discussionmentioning

confidence: 99%

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<p>Comparison of Iodide-125 and Ruthenium-106 Brachytherapy in the Treatment of Choroidal Melanomas</p>

Ghassemi¹,

Sheibani²,

Arjmand³

et al. 2020

OPTH

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Background: To compare iodine-125 ( 125 I) with ruthenium-106 ( 106 Ru) episcleral plaque radiation therapy in terms of the effectiveness and non-inferiority for choroidal melanoma treatment.Objective: To report the non-inferiority of new made iodine-125 ( 125 I) compared with ruthenium-106 ( 106 Ru) episcleral plaque radiation. Patients and Methods: A retrospective, non-randomized comparative case series. In this series the patients treated with 125 I and 106 Ru episcleral plaques for choroidal melanoma between September 2013 and August 2017 at Farabi Hospital are compared. Local control of choroidal melanomas after 125 I and 106 Ru plaques implantation and vision changes are the main outcome measures. Results: A total of 35 patients were identified ( 125 I = 15, 106 Ru = 20). No significant difference between two groups in visual acuity, diameter and thickness changes were observed after treatment. Multivariate linear regression (MLR) analysis showed that final diameter was only, independently and significantly, correlated with the pre-treatment diameter of the tumor (β = 0.59, 95% confidence interval [CI]: 0.29, 1.34, P = 0.003). The same MLR analysis for the final thickness and visual acuity, after adjusting for age and sex showed no significant difference between two groups. A single patient treated with 106 Ru had local tumor recurrence with no one in the 125 I group. No statistical difference in the rate of ocular complications was observed. Conclusion: The treatment with our 125 I plaques is as effective as 106 Ru plaques in controlling choroidal melanoma tumor and preserving the vision during the two and half year of follow-up. The complication rates are alike. It means that the effectiveness of 125 I is not only comparable to 106 Ru but also superior when the outcome of the interest is the thickness of the tumors.

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Section: Discussionmentioning

confidence: 99%

“…The plaques adopted for COMS plaques are designed and 125 I seed sources (each by 4.7 mm length and 0.8 mm in diameter) are made (the activity of 4-6 mCi). The 125 I plaques are 14,16,18,20,22 and 24 mm diameter round or notched and 1 mm thick gold shells. We used silastic carrier for 125 I seeds inside the gold shells.…”

Section: Methodsmentioning

confidence: 99%

<p>Comparison of Iodide-125 and Ruthenium-106 Brachytherapy in the Treatment of Choroidal Melanomas</p>

Ghassemi¹,

Sheibani²,

Arjmand³

et al. 2020

OPTH

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“…Current guidelines acknowledge pending questions regarding ideal prescription dose and dose rate, plaque size selection, and efficacy of notched and slotted plaques in preventing underdosing of juxtapapillary and circumpapillary tumors. Several publications have questioned the radiation therapy prescription dose and dose point [5][6][7][8][9][10][11][12][13]. Moreover, strict adherence to a planning treatment volume (PTV) with a 2-3 mm circumferential margin has been called into question.…”

Section: Introductionmentioning

confidence: 99%

Practice Patterns for the Treatment of Uveal Melanoma with Iodine-125 Plaque Brachytherapy: Ocular Oncology Study Consortium Report 5

et al. 2019

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Background: Treatment planning for I-125 plaque therapy for uveal melanoma has advanced significantly since the Collaborative Ocular Melanoma Study trial, with more widely available image-guided planning and improved dosimetry. Objective: We evaluated real-world practice patterns for I-125 plaque brachytherapy in the United States by studying practice patterns at centers that comprise the Ocular Oncology Study Consortium (OOSC). Methods: The OOSC database and responses to a treatment practice survey were eval-I-125 Plaque Brachytherapy Clinical Practices 211practices was high among OOSC institutions. Clinical margins and planning systems were similar among institutions, while prescription dose, dose rates, and dosimetry varied.

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“…To spare the optic disc and consequently, to reduce the contraindication, notched plaques were devised primarily for juxtapapillary or circumpapillary (overhanging the optic disc) tumors [3,10]. Notched COMS plaques, which have usually one radionuclide seed removed from standard COMS plaques, have been widely used [11]. Customized notched plaques or slotted plaques were also designed and have been used to accommodate the optic disc better than notched COMS plaques [3,10,12].…”

Section: Introductionmentioning

confidence: 99%

“…Although visual outcomes for the notched plaques mentioned above were reported [1,3,11,12], detailed dosimetry information on radiation dose reduction to the optic disc by the use of notched plaques has received little attention in the literature. Therefore, this study investigated dose reduction to the optic disc in ocular brachytherapy using 125I notched COMS plaques.…”

Section: Introductionmentioning

confidence: 99%

Investigation of optic disc dose reduction in ocular brachytherapy using 125I notched COMS plaques

Lee

Lin

Kim

2019

Preprint

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Background: Notched plaques were devised to reduce radiation dose to the optic disc in ocular brachytherapy. Although notched plaques have been widely used in clinic, optic disc dose reduction by the use of notched plaques has not been discussed in the literature. Therefore, this study investigated optic disc dose reduction in ocular brachytherapy using 125I notched Collaborative Ocular Melanoma Study (COMS) plaques based on our institutional practice. Methods: Using our in-house brachytherapy dose calculation program in which the American Association of Physicists in Medicine Task Group-43 Update (AAPM TG-43U1) dosimetry formalism with a line source approximation in a homogeneous water medium and COMS seed coordinates in the AAPM TG 129 were incorporated, optic disc doses for standard COMS plaques (from 12 mm to 22 mm in diameter in 2 mm increments) and notched COMS plaques with one seed removed (Case #1, from 12 mm to 22 mm in diameter in 2 mm increments) and two seeds removed (Case #2, from 14 mm to 22 mm in diameter) were calculated as a function of tumor margin-to-optic disc distance (DT) for various tumor basal dimensions (BDs) for prescription depths from 1 mm to 10 mm in 1 mm intervals. A prescribed dose was 85 Gy for an irradiation time of 168 hours to each prescription depth. Absolute and relative optic disc dose reduction by notched COMS plaques (Cases #1 and #2) for all prescription depths was calculated from optic disc dose differences between standard and notched COMS plaques. Results: Optic disc dose reduction by notched COMS plaques (Cases #1 and #2) had five unique trends which are related to maximum optic disc dose reduction and corresponding optimal DT for each BD in each plaque. Optic disc dose reduction increased with increasing prescription depth. Conclusions: The results presented in this study (magnitude of optic disc dose reduction and its trends) would enable the clinicians (both ophthalmologist and radiation oncologist) to choose an adequate plaque type among standard 125I COMS plaques and notched 125I COMS plaques (Cases #1 and #2) and a prescription depth to minimize optic disc dose for a given clinical case.

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Prescribing to tumor apex in episcleral plaque iodine-125 brachytherapy for medium-sized choroidal melanoma: A single-institutional retrospective review

Cited by 19 publications

References 23 publications

<p>Comparison of Iodide-125 and Ruthenium-106 Brachytherapy in the Treatment of Choroidal Melanomas</p>

<p>Comparison of Iodide-125 and Ruthenium-106 Brachytherapy in the Treatment of Choroidal Melanomas</p>

Practice Patterns for the Treatment of Uveal Melanoma with Iodine-125 Plaque Brachytherapy: Ocular Oncology Study Consortium Report 5

Investigation of optic disc dose reduction in ocular brachytherapy using 125I notched COMS plaques

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