title: Outcomes and control rates for I-125 plaque brachytherapy for uveal melanoma: a community-based institutional experience.
abstract: Purpose. To evaluate our community-based institutional experience with plaque brachytherapy for uveal melanomas with a focus on local control rates, factors impacting disease progression, and dosimetric parameters impacting treatment toxicity. Methods and Materials. Our institution was retrospectively reviewed from 1996 to 2011; all patients who underwent plaque brachytherapy for uveal melanoma were included. Follow-up data were collected regarding local control, distant metastases, and side effects from treatment. Analysis was performed on factors impacting treatment outcomes and treatment toxicity. Results. A total of 107 patients underwent plaque brachytherapy, of which 88 had follow-up data available. Local control at 10 years was 94%. Freedom from progression (FFP) and overall survival at 10 years were 83% and 79%, respectively. On univariate analysis, there were no tumor or dosimetric treatment characteristics that were found to have a prognostic impact on FFP. Brachytherapy treatment was well tolerated, with clinically useful vision (>20/200) maintained in 64% of patients. Statistically significant dosimetric relationships were established with cataract, glaucoma, and retinopathy development (greatest P = 0.05). Conclusions. Treatment with plaque brachytherapy demonstrates excellent outcomes in a community-based setting. It is well tolerated and should remain a standard of care for COMS medium sized tumors.
authors.affiliation: Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA.
authors.forename: Aaron
authors.identifier: 0000-0003-0316-4521
authors.initials: A
authors.lastname: Wagner
authors.affiliation: Department of Radiation Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA.
authors.forename: Andy
authors.identifier: 0000-0002-5388-2647
authors.initials: A
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Intermountain Medical Center, 5131 Cottonwood Street, Murray, UT 84107, USA.
authors.forename: Taylor
authors.initials: T
authors.lastname: Cook
authors.affiliation: Rocky Mountain Retina Associates, Murray, UT 84107, USA.
authors.forename: David
authors.identifier: 0000-0001-6849-0497
authors.initials: D
authors.lastname: Faber
authors.affiliation: Retina Associates of Utah, Murray, UT 84107, USA.
authors.forename: Kirk
authors.identifier: 0000-0001-8295-880X
authors.initials: K
authors.lastname: Winward
authors.affiliation: Department of Radiation Oncology, Intermountain Medical Center, 5131 Cottonwood Street, Murray, UT 84107, USA.
authors.forename: William
authors.identifier: 0000-0001-9170-7017
authors.initials: W
authors.lastname: Sause
references.citation: Am J Ophthalmol. 2004 Dec;138(6):936-51
references.pmid: 15629284
references.citation: Int J Radiat Oncol Biol Phys. 2005 Sep 1;63(1):101-8
references.pmid: 16111577
references.citation: Arch Ophthalmol. 1996 Nov;114(11):1357-65
references.pmid: 8906026
references.citation: Arch Ophthalmol. 2006 Dec;124(12):1684-93
references.pmid: 17159027
references.citation: Ophthalmology. 2011 Feb;118(2):402-7
references.pmid: 20813410
references.citation: Clin Exp Ophthalmol. 2005 Oct;33(5):490-4
references.pmid: 16181274
references.citation: Int J Radiat Oncol Biol Phys. 2003 Jun 1;56(2):544-55
references.pmid: 12738332
references.citation: Arch Ophthalmol. 2000 Sep;118(9):1219-28
references.pmid: 10980767
references.citation: Int J Radiat Oncol Biol Phys. 1991 May 15;21(1):109-22
references.pmid: 2032882
references.citation: Arch Ophthalmol. 2001 Jul;119(7):969-82
references.pmid: 11448319
references.citation: Ophthalmology. 1992 May;99(5):767-73; discussion 774
references.pmid: 1594224
references.citation: Retina. 2012 Jul;32(7):1363-72
references.pmid: 22466491
references.citation: Ophthalmology. 2002 Oct;109(10):1850-4
references.pmid: 12359605
references.citation: Eye (Lond). 2009 Jun;23(6):1254-68
references.pmid: 19265865
references.citation: Int J Radiat Oncol Biol Phys. 1993 Apr 2;25(5):815-20
references.pmid: 8478231
references.citation: Ophthalmol Clin North Am. 2005 Mar;18(1):75-84, viii
references.pmid: 15763193
references.citation: Int J Radiat Oncol Biol Phys. 1993 Jul 15;26(4):613-8
references.pmid: 8330990
references.citation: Int J Radiat Oncol Biol Phys. 2002 Mar 15;52(4):989-95
references.pmid: 11958893
references.citation: Cancer. 1996 Jun 1;77(11):2356-62
references.pmid: 8635107
references.citation: Ophthalmology. 2002 Oct;109(10):1838-49
references.pmid: 12359604
references.citation: Ophthalmology. 1984 Dec;91(12):1700-8
references.pmid: 6521999
references.citation: Arch Ophthalmol. 1999 May;117(5):609-14
references.pmid: 10326957
references.citation: Brachytherapy. 2011 Jul-Aug;10(4):331-9
references.pmid: 21349775
references.citation: Ophthalmology. 2002 Dec;109(12):2197-206
references.pmid: 12466159
references.citation: Ophthalmology. 2011 Sep;118(9):1881-5
references.pmid: 21704381
references.citation: Int J Radiat Oncol Biol Phys. 2010 Sep 1;78(1):98-103
references.pmid: 19910136
references.citation: Int J Radiat Oncol Biol Phys. 2003 Aug 1;56(5):1373-80
references.pmid: 12873683