Personalized re-treatment strategy for uveal melanoma local recurrences after interventional radiotherapy (brachytherapy): Single institution experience and systematic literature review

Luigi Azario, Maria Antonietta Gambacorta, Vincenzo Valentini, Maria Antonietta Blasi, Luca Tagliaferri, Monica Maria Pagliara, Andrea Scupola, Carmela Grazia Caputo, Valentina Lancellotta, Silvia Cammelli, Rafael Martinez-Monge, György Kovács

Risultato della ricerca: Contributo in rivistaArticolo in rivista

9 Citazioni (Scopus)

Abstract

Purpose: To report the results of a patient’s tailored therapeutic approach using a second course of interventional radiotherapy (brachytherapy) in patients with locally recurrent uveal melanoma. Material and methods: Patients who had already undergone ocular brachytherapy treated at our IOC (Interventional Oncology Center) were considered. Five patients who has received a second course of treatment with a plaque after local recurrences were included in our study. Re-irradiation was performed with Ruthenium-106 (prescribed dose to the apex 100 Gy) or with Iodine-125 plaques (prescribed dose to the apex 85 Gy). Moreover, a systematic literature search was conducted through three electronic databases, including Medline/PubMed, Scopus, and Embase. Results: All patients were initially treated with Ruthenium-106 plaque; the re-irradiation was performed with Ruthenium-106 plaque in three cases and with Iodine in two cases. Mean time between the first and the second plaque was 56.8 months (range, 25-93 months). Local tumor control rate was 100%, no patient underwent secondary enucleation owing to re-treatment failure. Distant metastasis occurred in 1 patient after 6 months from re-treatment. After a median follow-up of 44.2 months (range, 26-65 months) from re-treatment, all patients experienced worsening of the visual acuity (median visual acuity was 0.42 at time of recurrence and decline to 0.24 at the most recent follow-up); cataract occurred in two cases, no patient developed scleral necrosis. We considered 2 papers for a systematic review. Conclusions: In selected cases, especially in presence of marginal local recurrence, a personalized re-treatment strategy with a plaque may offer high probability of tumor control and organ preservation but worsening of visual acuity.
Lingua originaleEnglish
pagine (da-a)54-60
Numero di pagine7
RivistaJournal of Contemporary Brachytherapy
Volume11
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Brachytherapy
  • Re-irradiation
  • Re-treatment
  • Uveal melanoma

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