Ruthenium-106 brachytherapy for iris and iridociliary melanomas

Marinković, Marina; Horeweg, Nanda; Laman, M.S.; Bleeker, J.C.; Ketelaars, M.; Peters, Femke P.; Luyten, Gré P.M.; Creutzberg, Carien L.

doi:10.1136/bjophthalmol-2017-310688

Cited by 14 publications

(19 citation statements)

References 25 publications

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“…However, 125 I is preferred in larger tumors due to its physical properties, namely, emission of gamma radiation which penetrates deeper than beta-emitters like 106 Ru. These observations were confirmed in several studies [ 27 , 28 , 29 , 30 , 31 ]. Intraoperative ultrasonography to verify plaque placement improved the treatment results, especially for tumors localized in anatomically challenging eye parts, such as its posterior area [ 32 , 33 , 34 ].…”

Section: Radiotherapysupporting

confidence: 81%

New Perspectives for Eye-Sparing Treatment Strategies in Primary Uveal Melanoma

Bilmin

Synoradzki

Czarnecka

et al. 2021

Cancers

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Uveal melanoma is the most common intraocular malignancy and arises from melanocytes in the choroid, ciliary body, or iris. The current eye-sparing treatment options include surgical treatment, plaque brachytherapy, proton beam radiotherapy, stereotactic photon radiotherapy, or photodynamic therapy. However, the efficacy of these methods is still unsatisfactory. This article reviews several possible new treatment options and their potential advantages in treating localized uveal melanoma. These methods may be based on the physical destruction of the cancerous cells by applying ultrasounds. Two examples of such an approach are High-Intensity Focused Ultrasound (HIFU)—a promising technology of thermal destruction of solid tumors located deep under the skin and sonodynamic therapy (SDT) that induces reactive oxygen species. Another approach may be based on improving the penetration of anti-cancer agents into UM cells. The most promising technologies from this group are based on enhancing drug delivery by applying electric current. One such approach is called transcorneal iontophoresis and has already been shown to increase the local concentration of several different therapeutics. Another technique, electrically enhanced chemotherapy, may promote drug delivery from the intercellular space to cells. Finally, new advanced nanoparticles are developed to combine diagnostic imaging and therapy (i.e., theranostics). However, these methods are mostly at an early stage of development. More advanced and targeted preclinical studies and clinical trials would be needed to introduce some of these techniques to routine clinical practice.

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Section: Radiotherapysupporting

confidence: 81%

New Perspectives for Eye-Sparing Treatment Strategies in Primary Uveal Melanoma

Bilmin

Synoradzki

Czarnecka

et al. 2021

Cancers

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“…However, 125 I is preferred in larger tumors due to its physical properties, namely emission of gamma radiation which penetrates deeper than beta-emitters like 106 Ru. These observations were confirmed in several studies [24][25][26][27][28]. Intraoperative ultrasonography to verify plaque placement improved the treatment results, especially for tumors localized in the anatomically challenging eye parts, such as its posterior area [29][30][31].…”

Section: Brachytherapysupporting

confidence: 54%

New Perspectives for Eye-Sparing Treatment Strategies in Primary Uveal Melanoma

Bilmin¹,

Synoradzki²,

Czarnecka³

et al. 2021

Preprint

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Uveal melanoma is the most common intraocular malignancy and arises from melanocytes in the choroid, ciliary body, or iris. Radiotherapy is the mainstay of therapy for most patients with localized uveal melanoma. Another RT technique used in the treatment of uveal melanomas is charged-particle radiotherapy. Photodynamic therapy is based on the selective destruction of cancer cells or pathological vessels. High-Intensity Focused Ultrasound (HIFU) is a promising technology of thermal destruction of solid tumors located deep under the skin. The principle of operation is based on the heating of a tumor. Sonodynamic therapy (SDT) induces the reactive oxygen species and kills cancer cells. Electroporation applied in vivo delivers drugs or genetic material from the intercellular space to cells. Iontophoresis is a technique in which using electric current increases the biodistribution of drugs in the eyeball. Transcorneal iontophoresis has been shown to increase the local concentration of antibacterial and antifungal drugs, steroids, DNA, and RNA molecules. Theranosticsincorporates diagnostic imaging and therapy. Although no theranostic markers have been developed specifically for uveal melanoma, some NPs have already found use in ophthalmology. UM presents an unmet clinical need. Novel eye-preserving therapeutic approaches for the localized disease are needed.

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“…A total of 12 studies (3 prospective and 9 retrospective) were included in this review ( Table 1 ) [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. 125 I, 103 Pd, and 106 Ru plaques were used in 3, 5, and 4 studies, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Even though there were concerns about scleral and corneal necrosis and melting, only one study reported scleral necrosis (2%) following plaque removal [ 23 ]. Similarly, radiation retinopathy was rarely reported (4% in one study only) [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications

Karimi

Arabi

Shahraki

2021

jcb

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Purpose To evaluate the efficacy and vision-threatening complication rate of plaque brachytherapy with iodine-125 ( 125 I), palladium-103 ( 103 Pd), and ruthenium-106 ( 106 Ru) for treatment of iris and iridociliary melanoma. Material and methods A literature review was done based on results yielded from searching PubMed, Embase, and Cochrane database, using following key words: iris melanoma, iridociliary melanoma, brachytherapy, iodine-125 brachytherapy, palladium-103 brachytherapy, and ruthenium-106 brachytherapy. Initially, relationships between mean radiation dose to apex and local recurrence and complication rate were analyzed, and then, a comparison was performed between 125 I, 103 Pd, and 106 Ru studies. Results Twelve retrospective and prospective studies were selected, with 491 patients treated primarily with plaque brachytherapy. The range of radiation dose to tumor apex were from 84 to 151.5 Gy. Ranges of mean and median of follow-up time were from 27 to 96 months. Local recurrence rate following brachytherapy ranged from 0 to 8%. A decrease in the average study dose was not associated with an increased local recurrence or metastasis rate ( p = 0.373 and 0.195, respectively); however, an increase in radiation dose was associated with higher radiation-related cataract and glaucoma ( p < 0.05). The rate of post-treatment glaucoma was higher in studies with 125 I plaque brachytherapy ( p = 0.004). Conclusions For brachytherapy of iris and iridociliary melanoma, in a range of 84 to 150 Gy, an increase in radiation dose may increase the risk of complications, while the tumor control rate does not change.

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Ruthenium-106 brachytherapy for iris and iridociliary melanomas

Abstract: Ru106 for IM and ICM yielded excellent local control (98.9%) and eye preservation (97.7%). Toxicities were common, but mostly mild and transient. Moreover, Ru106 did not affect visual acuity.

Cited by 14 publications

References 25 publications

New Perspectives for Eye-Sparing Treatment Strategies in Primary Uveal Melanoma

New Perspectives for Eye-Sparing Treatment Strategies in Primary Uveal Melanoma

New Perspectives for Eye-Sparing Treatment Strategies in Primary Uveal Melanoma

Plaque brachytherapy in iris and iridociliary melanoma: a systematic review of efficacy and complications

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