PREDICTORS OF TREATMENT RESPONSE OF VASOPROLIFERATIVE RETINAL TUMORS TO RUTHENIUM-106 BRACHYTHERAPY.
OBJECTIVE
To identify predictors of treatment response by evaluating long-term outcomes of vasoproliferative retinal tumors after ruthenium-106 brachytherapy.


METHODS
In a retrospective case series, 39 eyes of 38 patients with vasoproliferative retinal tumors received ruthenium-106 brachytherapy between 2001 and 2013. Baseline clinical and morphologic parameters were analyzed regarding posttreatment tumor activity status.


RESULTS
Within a median follow-up period of 2.9 ± 2.9 years, overall, a tumor inactivation was achieved in 72% of cases and visual acuity remained stable in 69%. The mean apex dose was 90 ± 23 Gy (range, 51-140 Gy). Mean tumor thickness decreased significantly, from 2.9 ± 0.9 mm to 1.5 ± 1.0 mm (P < 0.001; paired t-test). Persistence or recurrence of tumor activity occurred in 28% of cases, requiring secondary intervention with intravitreal drug injections, vitrectomy, cryotherapy, or repeated brachytherapy. Comparison of inactive and active vasoproliferative retinal tumors revealed significant correlation between both initial basal tumour diameter and area and subsequent tumour activity status. In particular, a diameter >7.5 mm was associated with an 8-fold risk of persistent or recurrent activity, whereas basal area >40 mm demonstrated a 6-fold risk (P = 0.009 and 0.021, respectively; Fisher's exact-test). In contrast, tumor thickness was not found to be of prognostic relevance.


CONCLUSIONS
Ruthenium-106 brachytherapy is an effective and safe therapeutic option for vasoproliferative retinal tumors. Additionally, tumor diameter and area are efficient predictors of persistence or recurrence of tumor activity.
*Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Berlin, Germany; †Berlin Institute of Health (BIH), Berlin, Germany; and ‡Berlin Protonen, Helmholtz-Zentrum Berlin für Materialien und Energie, Charité - Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany.
Claudia
C
Brockmann
Matus
M
Rehak
Jens
J
Heufelder
Dino
D
Cordini
Tobias
T
Brockmann
Caitlin
C
Corkhill
Antonia M
AM
Joussen
Annette
A
Hager
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009383:Neoplasms, Vascular Tissue / Q000532:radiotherapy*; D019572:Retinal Neoplasms / Q000532:radiotherapy*; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D014792:Visual Acuity; D055815:Young Adult
D012429:Ruthenium Radioisotopes