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Ocular brachytherapy

David Reichstein, Kayla Karan
PURPOSE OF REVIEW: Plaque brachytherapy remains the dominant globe-sparing therapy of uveal melanoma. This report highlights recent advances, which have expanded plaque brachytherapy's uses as well as improved the surgical technique. RECENT FINDINGS: Plaque brachytherapy is effective for tumors that may previously have demanded enucleation. Plaque brachytherapy can be used to control large melanomas as well as melanomas touching the optic nerve. Improvements in planning and design have made plaque therapy simpler for the surgical operator and may reduce collateral radiation damage to normal ocular structures...
March 13, 2018: Current Opinion in Ophthalmology
Aline I Riechardt, Julian P Klein, Dino Cordini, Jens Heufelder, Matus Rehak, Ira Seibel, Antonia M Joussen
PURPOSE: This study aims to analyze the effect of salvage proton beam therapy for the treatment of recurrent iris melanoma. METHOD: In this clinical case series, we retrospectively analyzed the data of eight patients who underwent proton beam therapy of the whole anterior segment as salvage therapy between 2000 and 2016 for recurrent iris melanoma after resection, ruthenium brachytherapy, or sector proton beam therapy. Two patients received salvage proton beam therapy for repeated tumor relapse...
February 20, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Iwona Rospond-Kubiak, Marta Wróblewska-Zierhoffer, Hanna Twardosz-Pawlik, Jarosław Kocięcki
Purpose: The aim of this study was to report on results of uveal melanoma treatment with ruthenium-106 (106 Ru) brachytherapy with long-term follow-up, in terms of local tumor control, eye retention rate, radiation retinopathy, and patients' survival. Material and methods: Medical records of patients treated with ruthenium plaque due to uveal melanoma at the Department of Ophthalmology, Poznan University of Medical Sciences, Poland, between 1994 and 2014 were retrospectively reviewed...
December 2017: Journal of Contemporary Brachytherapy
Siddhartha Laskar, Avinash Pilar, Nehal Khanna, Yogesh Ghadi
Purpose: To report an innovative technique of interstitial brachytherapy developed for treatment of orbital soft tissue tumors. Material and methods: A 4-month-old child diagnosed with rhabdomyosarcoma of orbit was treated with multiagent chemotherapy (CTh) and brachytherapy. Pre-planning computed tomography (CT) images were obtained and clinical target volume (CTV) was defined using the pre-treatment magnetic resonance imaging (MRI). Brachytherapy plan was generated for deciding optimal catheter placement...
October 2017: Journal of Contemporary Brachytherapy
Yuan James Rao, Julia Sein, Shahed Badiyan, Julie K Schwarz, Todd DeWees, Perry Grigsby, Prabakar Kumar Rao
Purpose: The Collaborative Ocular Melanoma Study (COMS) established modern treatment recommendations for uveal melanoma. We aim to evaluate patterns of care and survival outcomes in the time after COMS. Material and methods: The retrospective study population includes 2,611 patients in the SEER database treated for uveal melanoma between 2004-2013. Patients stage were T1-4N0M0. Data analyzed included age, clinical stage, tumor size, race, and treatment. Treatments included enucleation (EN) and globe preserving therapy (GPT), which consisted of limited surgical resection or ablation (LSRA), external beam radiation (EBRT), or brachytherapy (BT)...
October 2017: Journal of Contemporary Brachytherapy
Magnolia Trinidad Cano-Suárez, María Antonia Saornil-Álvarez, Ciro García-Álvarez, Francisco López-Lara, Jesús María Frutos-Baraja, Elena García-Lagarto
A pseudophakic 70-year-old man presented to the clinic with a slow-growing conjunctival mass in the left eye. He was diagnosed with a conjunctival exophytic lesion suspicious of invasive conjunctival squamous cell carcinoma (CSCC). Excisional biopsy showed a well-differentiated CSCC with positive margins and the patient underwent adjuvant brachytherapy. Six weeks later, examination of the anterior segment revealed cells in the anterior chamber and a neurotrophic corneal ulcer with corneal perforation. Considering the high suspicion of intraocular invasion of CSCC, the left eye was enucleated...
September 2017: Ocular Oncology and Pathology
Andrea L H Arnett, Margaret M Reynolds, Jose S Pulido, Ian F Parney, Nadia N Laack
BACKGROUND: Gamma knife radiosurgery (GKR) can be used for precise targeting of malignant lesions of the CNS when brachytherapy is not an appropriate option. OBJECTIVES: This study reports treatment technique, efficacy, and radiation-induced adverse effects in patients with primary and metastatic ocular lesions treated with Leksell GKR. METHODS: A retrospective, single-institution review was conducted of 28 patients with primary or metastatic ocular disease, treated from 2000 to 2014...
November 4, 2017: Stereotactic and Functional Neurosurgery
Tara A McCannel, EunAh Kim, Mitchell Kamrava, James Lamb, Joseph Caprioli, Dong Yang, Colin A McCannel
PURPOSE: Radiation retinopathy remains incompletely characterized and may cause severe vision loss. Ultra-wide-field fluorescein angiography provides a pan-fundus view of vascular alterations caused by radiation treatment and may predict visual and ocular outcomes. We have developed a grading scheme to describe pan-fundus severity and to predict the progression of radiation retinopathy in patients treated for uveal melanoma with iodine-125 brachytherapy. METHODS: A retrospective review of patients treated with standard iodine-125 brachytherapy for uveal melanoma at the Ophthalmic Oncology Center at the University of California, Los Angeles, who had undergone both baseline and postbrachytherapy ultra-wide-field fluorescein angiography...
October 6, 2017: Retina
Simone Luisa Scholz, Anja Eckstein, Dirk Dekowski, Joachim Esser, Henrike Westekemper, Klaus P Steuhl
This article is a review of diagnostic and therapeutic possibilities in common epibulbar malignant tumors, such as basal cell carcinoma, conjunctival lymphoma, squamous cell carcinoma and conjunctival melanoma. Most importantly, for every tumor patient there is a detailed anamnesis, split lamp examination and photo documentation. Further regular controls after therapy are required due to the risk of recurrences.Basal cell carcinoma is the most common tumor of the periocular skin, divided into three subtypes (nodular, superficial and morphea)...
September 12, 2017: Klinische Monatsblätter Für Augenheilkunde
Jasmine H Francis, Jonathan Kim, Amy Lin, Robert Folberg, Saipriya Iyer, David H Abramson
PURPOSE: Typically treatment of large melanomas (by Collaborative Ocular Melanoma Study criteria) is restricted to enucleation, due to size constraints for plaque brachytherapy. Because primary and metastatic uveal melanoma cells are inhibited by bevacizumab (an anti-vascular endothelial growth factor), this prospective study evaluated the impact of intravitreal bevacizumab on large uveal melanomas that were destined for enucleation. Size reduction by bevacizumab would potentially salvage these eyes by making them eligible for treatment with plaque brachytherapy...
July 2017: Ocular Oncology and Pathology
Yongsook C Lee, Yongbok Kim, Jason Wei-Yeong Huynh, Russell J Hamilton
PURPOSE: The aim of the study was to identify potential failure modes (FMs) having a high risk and to improve our current quality management (QM) program in Collaborative Ocular Melanoma Study (COMS) ocular brachytherapy by undertaking a failure modes and effects analysis (FMEA) and a fault tree analysis (FTA). METHODS AND MATERIALS: Process mapping and FMEA were performed for COMS ocular brachytherapy. For all FMs identified in FMEA, risk priority numbers (RPNs) were determined by assigning and multiplying occurrence, severity, and lack of detectability values, each ranging from 1 to 10...
August 18, 2017: Brachytherapy
Jacqueline Esthappan Zoberi, Jose Garcia-Ramirez, Samantha Hedrick, Vivian Rodriguez, Carol G Bertelsman, Stacie Mackey, Yanle Hu, H Michael Gach, P Kumar Rao, Perry W Grigsby
PURPOSE: Episcleral plaque brachytherapy (EPB) planning is conventionally based on approximations of the implant geometry with no volumetric imaging following plaque implantation. We have developed an MRI-based technique for EPB treatment planning and dose delivery verification based on the actual patient-specific geometry. METHODS AND MATERIALS: MR images of 6 patients, prescribed 85 Gy over 96 hours from Collaborative Ocular Melanoma Study-based EPB, were acquired before and after implantation...
August 14, 2017: Brachytherapy
Shatha H Alfreihi, Stacy L Pineles, Tara A McCannel, Angelica M Prada, Federico G Velez
PURPOSE: To characterize intraoperative findings, surgical approach, and postoperative outcomes in patients undergoing strabismus surgery following plaque brachytherapy for ocular melanoma. METHODS: The records of all patients who underwent plaque brachytherapy for choroidal melanoma between May 2007 and June 2016 were reviewed retrospectively to identify those who subsequently required strabismus surgery. RESULTS: Of the 461 patients who underwent plaque brachytherapy during the study period, 13 (2...
July 18, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Sara Sánchez-Tabernero, Ciro García-Alvarez, Ma Fe Muñoz-Moreno, Patricia Diezhandino, Pilar Alonso-Martínez, Jesus M de Frutos-Baraja, Francisco López-Lara, Maria A Saornil
PURPOSE: To describe the time, frequency, and clinical characteristics of treatment failure after I-125 brachytherapy in patients with uveal melanoma treated and followed in a Spanish referral ocular oncology unit. DESIGN: Prospective, consecutive, interventional case series. METHODS: Patients diagnosed with uveal melanoma from 1995 to 2016 and treated with episcleral brachytherapy were included. Demographic data collection, ophthalmic evaluation, ultrasound scan, and systemic studies were performed at baseline, every 6 months thereafter for 5 years, and subsequently at annual intervals...
August 2017: American Journal of Ophthalmology
Prithvi Mruthyunjaya, Michael I Seider, Sandra Stinnett, Amy Schefler
PURPOSE: Gene expression profile (GEP) testing segregates uveal melanoma (UM) into 2 main prognostic classes. It is unknown if a greater tumor regression response after iodine 125 (I(125)) brachytherapy correlates with class 2 GEP status. The purpose of this study was to determine whether there is a significant relationship between the rate of UM height regression and GEP classification testing after I(125) plaque brachytherapy. DESIGN: Multicenter, retrospective cohort study...
October 2017: Ophthalmology
Hadi Rezaei, Mansour Zabihzadeh, Mahdi Ghorbani, Foad Goli Ahmadabad, Hesameddin Mostaghimi
In recent years, the use of gold nanoparticles in radiation therapy has been introduced as a new approach in radiotherapy. The aim of this study is to investigate the effect of gold nanoparticles (GNPs) in plaque brachytherapy for choroidal melanoma using Monte Carlo (MC) simulation. MCNPX code was used for simulation of human eye, (103)Pd (model 200) brachytherapy source and the 20 mm COMS eye plaque that was loaded with 24 (103)Pd seeds and standardized by Collaborative Ocular Melanoma Study (COMS). The tumour was defined from the inner surface of choroid with 0...
September 2017: Australasian Physical & Engineering Sciences in Medicine
Brianna C Kopp, R Trafford Crump, Ezekiel Weis
OBJECTIVE: There are limited studies on uveal melanoma and patient quality of life. However, the burden of implementing a patient-reported outcome measure to collect this information in a clinical setting is unknown. The objectives of this study were (i) to understand the issues of quality of life that are most important to patients undergoing treatment for uveal melanoma, (ii) to explore patient views on the European Organization for Research and Treatment of Cancer's (EORTC) ophthalmic oncology quality of life questionnaire (QLQ-OPT30), and (iii) to assess patient willingness to complete questionnaires measuring quality of life on an ongoing basis...
April 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Anne W Tann, Bin S Teh, Sarah B Scarboro, Gary D Lewis, Maria E Bretana, Porshea C Croft, Yuval Raizen, E Brian Butler, Ryan S Kim, Patricia Chevez-Barrios, Amy C Schefler
PURPOSE: To report early outcomes of patients with uveal melanoma treated with Eye Physics iodine-125 episcleral plaque therapy using modern biopsy techniques and intraoperative ultrasound guidance at our institution. METHODS AND MATERIALS: A retrospective chart review was conducted for 48 consecutive patients with uveal melanoma who were treated with Eye Physics plaque brachytherapy performed by 1 ocular oncologist. All patients underwent intraoperative ultrasound for image guidance of plaque placement...
January 7, 2017: Practical Radiation Oncology
G Ece Akinci, Ahmet M Hondur, Tongalp H Tezel
PURPOSE: To describe intraocular use of bevacizumab for a metastatic breast carcinoma of the iris resistant to advanced systemic chemotherapy protocols, for which conventional treatment would be local radiotherapy or brachytherapy. METHODS: Case report. RESULTS: A 65-year-old woman, who was previously diagnosed with breast carcinoma and treated with radical mastectomy coupled with radiotherapy and chemotherapy, presented with an iris mass in her left eye...
March 24, 2017: Retinal Cases & Brief Reports
Somayeh Asadi, Mehdi Vaez-Zadeh, Mohammad Vahidian, Mahdieh Marghchouei, S Farhad Masoudi
The aim of the present Monte Carlo study is to evaluate the variation of energy deposition in healthy tissues in the human eye which is irradiated by brachytherapy sources in comparison with the resultant dose increase in the gold nanoparticle (GNP)-loaded choroidal melanoma. The effects of these nanoparticles on normal tissues are compared between 103Pd and 125I as two ophthalmic brachytherapy sources. Dose distribution in the tumor and healthy tissues has been taken into account for both brachytherapy sources...
May 2016: Journal of Applied Clinical Medical Physics
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