Efficacy and Safety of Low-Dose Iodine Plaque Brachytherapy for Juxtapapillary Choroidal Melanoma.

Published

Journal Article

PURPOSE: To evaluate low- vs high-dose plaque brachytherapy for juxtapapillary choroidal melanoma. DESIGN: Retrospective interventional case series. METHODS: Setting: Single institution. STUDY POPULATION: Forty-seven patients with juxtapapillary choroidal melanoma. INTERVENTION: Iodine-125 plaque brachytherapy. Eyes were divided into apex low-dose (LD) and high-dose (HD) groups (≤ or > median apex dose 84.35 Gy). Main outcome measures were time to distant failure, local failure, death, enucleation, radiation retinopathy, optic neuropathy, and best-corrected visual acuity (BCVA). RESULTS: Freedom from distant failure rates were 96% and 95% in apex LD and HD groups at 5 years and 77% and 95% at 10 years, respectively (P = .84). Freedom from local failure rates were 90% in the apex LD group vs 89% in the HD group at 5 and 10 years (P = .96). Apex LD and HD groups did not differ for time to death or enucleation. Five- and 10-year freedom from radiation retinopathy and optic neuropathy rates were higher in the apex LD than HD group. Loss of ≥3 BCVA lines, final BCVA 20/40 or better, and final BCVA 20/200 or worse were more favorable in the 5 mm LD compared to HD group. Visual acuity outcomes did not differ between apex LD and HD groups. CONCLUSIONS: Low-dose iodine-125 plaque brachytherapy (67.5-81 Gy at tumor apex) provides safe and effective tumor control for juxtapapillary choroidal melanoma and may be associated with reduced radiation toxicity. Larger trials are needed to determine the optimal therapeutic dose for juxtapapillary choroidal melanoma.

Full Text

Duke Authors

Cited Authors

  • Oellers, P; Mowery, YM; Perez, BA; Stinnett, S; Mettu, P; Vajzovic, L; Light, K; Steffey, BA; Cai, J; Dutton, JJ; Buckley, EG; Halperin, EC; Marks, LB; Kirsch, DG; Mruthyunjaya, P

Published Date

  • February 2018

Published In

Volume / Issue

  • 186 /

Start / End Page

  • 32 - 40

PubMed ID

  • 29199010

Pubmed Central ID

  • 29199010

Electronic International Standard Serial Number (EISSN)

  • 1879-1891

Digital Object Identifier (DOI)

  • 10.1016/j.ajo.2017.11.008

Language

  • eng

Conference Location

  • United States