Advertisement
Review Article| Volume 47, ISSUE 3, P273-279, September 2022

Download started.

Ok

Ocular malignancies treated with iodine-125 low dose rate (LDR) brachytherapy at a single high-volume institution: A retrospective review

      ABSTRACT

      The aim of our study is to document our cases of choroidal melanoma treated with low dose rate (LDR) brachytherapy and to correlate the dosimetry and radiobiology with clinical effects and oncologic outcomes. Data from 157 patients treated from 2014 to 2018 with LDR brachytherapy were used for this investigation. Treatments used a collaborative ocular melanoma study eye plaque and Iodine-125 radioactive seeds. The seeds activities were chosen to deliver 85 Gy to the tumor apex or to a prescription point (if the apex < 5 mm). The plaque sizes used were 10, 12, 14, 16, 18, 20, and 22 mm including notched or deep notched. The plaques were modeled in Varian BrachyVision version 11.6 (Varian Medical Systems) with seed coordinates from the AAPM Task Group 129. The Task Group 43 from AAPM was used for brachytherapy dose planning. Dose data were extracted for the apex, prescription point, sclera, retina opposite to the implant, lens, macula, and optic disc. The radiobiological dosimetry were calculated using appropriate α/β ratios found in the literature and then correlated to clinical side effects. Average biologically effective dose for associated organs at risk were calculated in cases where toxicity occurred. These included: radiation cataract (70.66 Gy), disc atrophy (475.49 Gy), foveal atrophy (263.07 Gy), radiation papillopathy (373.45 Gy), radiation maculopathy (213.62 Gy), vitreous hemorrhage (1437.68 Gy), vascular occlusion (1080.93 Gy), nonproliferative retinopathy (1066.89 Gy), proliferative retinopathy (1590.71 Gy), exudative retinal detachment (1364.32 Gy), and rhegmatogenous retinal detachment (2265.54 Gy). Average biologically effective dose was higher in patients who developed radiation induced long term side effects than in the whole patient population except for radiation maculopathy. In spite of the small patient population and short-term follow-up, it is of interest to correlate the radiation induced effects and create a guideline for the improvement of the treatment of patients treated with LDR brachytherapy.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Medical Dosimetry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. American Cancer Society. Cancer Facts & Figures 2021. Atlanta: American Cancer Society; 2021.

      2. Cancer.Net. Editoral Board. Eye Cancer - Statistics. Cancer.Net Articles. Alexandria: American Society of Clinical Oncology (ASCO); 2012.

        • Muller L
        • Henson C
        • Firestone B
        • et al.
        Radiation treatment to a postresection primary mucoepidermoid carcinoma (MEC) of the conjunctiva with positive margins at the Tenon's fascia—A case study.
        Med Dosimetry. 2019; 44: 245-250
        • Miguel D.
        • de Frutos-Baraja J.M.
        • López-Lara F.
        • et al.
        Radiobiological doses, tumor, and treatment features influence on local control, enucleation rates, and survival after epiescleral brachytherapy. A 20-year retrospective analysis from a single-institution: Part II.
        J Contemp Brachyther. 2018; 10: 347-359
        • Archer DB
        • Amoaku WMK
        • Gardiner TA
        Radiation retinopathy-clinical, histopathologica, ultrastructural and experimental correlation.
        Eye. 1991; 5: 239-251
        • Blasi M.A.
        • Pagliara M.M.
        • Lanza A.
        • et al.
        Photodynamic therapy in ocular oncology.
        Biomedicines. 2018; 6
        • Harbour J.W.
        Rate of resolution of exudative retinal detachment after plaque radiotherapy for uveal melanoma.
        Arch Ophthalmol. 2002; 120: 1463
        • Gündüz K.
        Radiation retinopathy following plaque radiotherapy for posterior uveal melanoma.
        Arch Ophthalmol. 1999; 117: 609
        • Wen J.C.
        • Mccannel T.A.
        Treatment of radiation retinopathy following plaque brachytherapy for choroidal melanoma.
        Curr Opinion Ophthalmol. 2009; 20: 200-204
        • Chiu-Tsao S.
        • Astrahan M.
        • Finger P.
        • et al.
        Dosimetry of 125I and 103Pd COMS eye plaques for intraocular tumors: report of Task Group 129 by the AAPM and ABS.
        Med Phys. 2012; 39: 6161-6184
        • Collaborative Ocular Melanoma Study Group
        The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report no. 28.
        Arch Ophthalmol. 2006; 124: 1684-1693
        • Rivard M.J.
        • Coursey B.M.
        • DeWerd L.A.
        • et al.
        Update of AAPM Task Group No.43 report: a revised AAPM protocol for brachytherapy dose calculations.
        Med Phys. 2004; 31: 633-674
        • Dale R.G.
        • Jones B.
        The clinical radiobiology of brachytherapy.
        Br J Radiol. 1998; 71: 465-483
        • Gagne N.L.
        • Leonard K.
        • Rivard M.
        Radiobiology for eye plaque brachytherapy and evaluation of implant duration and radionuclide choice using an objective function.
        Med Phys. 2012; 39: 3332-3342
        • Miguel D.
        • de Frutos-Baraja J.M.
        • López-Lara F.
        • et al.
        Visual outcome after posterior uveal melanoma episcleral brachytherapy including radiobiological doses.
        J Contemp Brachyther. 2018; 10: 123-131https://doi.org/10.5114/jcb.2018.75597
        • Gündüz K.
        • Shields C.L.
        • Shields J.A.
        • et al.
        Radiation complications and tumor control after plaque radiotherapy of choroidal melanoma with macular involvement.
        Am J Ophthalmol. 1999; 127: 579-589
        • Peddada K.V.
        • Sangani R.
        • Menon H.
        • et al.
        Complications and adverse events of plaque brachytherapy for ocular melanoma.
        J Contemp Brachyther. 2019; 11: 392-397
        • Freire J.E.
        • De Potter P.
        • Brady L.W.
        • et al.
        Brachytherapy in primary ocular tumors.
        Semin Surg Oncol. 1997; 13: 167-176