[Criteria for assessing the efficacy of brachytherapy of uveal melanomas, complications of therapy and there prevention].
The authors assess the efficacy of brachytherapy of uveal melanomas in 954 patients. Strontium ophthalmoapplicators were used in 652, rutenium ones in 302 patients. As a rule, Sr applicators were sutured in patients with tumors up to 3.5 mm thick and Ru ones in cases with tumors thicker than 3.5 mm. A special program was used for individual approach and improving the accuracy of planning. A total of 74.5% of patients have been followed up for at least 3 years, with check-ups every 3-6 months. The effect of brachytherapy was considered positive in cases with complete resorption or at least 50% decrease of the tumor and a stable clinical picture for 9-12 months. In 60% of patients the tumor regressed completely, in 16% partially, and in 24% there were signs of activation of melanoma growth one year after treatment. The frequency of radiation complications was as follows: retinopaty, 3.15%; neuroretinopathy, 1.1%; hemophthalmia, 0.9%; neovascular glaucoma, 1.1%; cataract, 0.63%. The incidence of radiation complications increases with increase of the applicator power and rigidity of exposure. Computer planning of brachytherapy with due consideration for the size of the tumor and the eye and localization of the neoplasm for each case will help decrease the incidence of complications.
Brovkina
A F
AF
Department of Ophthalmooncology and Radiology, Moscow NII of Eye Diseases.
Zarubeí
G D
GD
Val'skií
V V
VV
D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008545:Melanoma / Q000175:diagnosis / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D013326:Strontium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*
D012429:Ruthenium Radioisotopes; D013326:Strontium Radioisotopes