Local control, metastasis and visual function after brachytherapy in choroidal melanoma.
Mercedes Gonzalez Cantero,
Spain
OC-0616
Abstract
Local control, metastasis and visual function after brachytherapy in choroidal melanoma.
Authors: Mercedes González Cantero1, Macarena Teja Ubach1, Marta Rodríguez Roldán1, Maria Isabel Garrido Botella1, Elisabet González Del Portillo1, Ane Escribano Uzcudun1, Isabel Rodríguez Rodríguez1, Rosa María Morera López1
1Hospital Universitario La Paz, Oncología Radioterápica, Madrid, Spain
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Purpose or Objective
Uveal melanoma is the most common primary
intraocular tumor. The first-choice treatment in medium-sized tumors is
episcleral-plaque brachytherapy.
Our aims are:
1)
To study the efficacy
of brachytherapy in choroidal melanoma with the goal of local tumor control and
conservation of eyeball and its function.
2)
To study
progression-free survival at 5 years from treatment.
Material and Methods
Retrospective observational study including 100 patients with choroidal
melanoma treated with brachytherapy with plaques loaded with Iodine125
or Ruthenio106. Local tumor control and evaluation of metastasis
were performed periodically using ocular ultrasound, fundoscopy, retinography
and body-TC.
Results
Visual function was preserved in 78% of patients.
Eyeball was preserved in 81%. Characteristics of patients and tumours are
described in Table 1. Local tumor control was achieved in 82%. After 5 years of
follow-up, 88% of patients have not developed distant metastasis. 66% of
metastasis were localized in liver, 33% in lungs and there was one
case with disease affecting lungs and bone at the same time. Enucleation was
carried out in 19 patients, of whom 37% of cases were due to treatment toxicity
while the remaining 63% of enucleations were due to lack of local control.
Metastasis development was higher in enucleated patients than in patients with
eyeball conservation (p=0.047) (Figure 1). 50% of enucleated patients due to
lack of local control developed distant disease in the follow up.
Conclusion
Our study shows that treatment with
episcleral-plaque brachytherapy achieves good results in eyeball conservation
and visual function preservation, with a high local tumor control and
progression-free survival, according to the literature.
In addition, this study suggests that local
tumor control in choroidal melanoma has an impact on progression-free survival.
We conclude that treatment with episcleral-plaque brachytherapy is a safe and effective procedure in choroidal melanoma.