Outcomes of iodine-125 plaque brachytherapy for uveal melanoma with intraoperative ultrasonography and supplemental transpupillary thermotherapy

Shahed N. Badiyan, Rajesh C. Rao, Anthony J. Apicelli, Sahaja Acharya, Vivek Verma, Adam A. Garsa, Todd DeWees, Christina K. Speirs, Jose Garcia-Ramirez, Jacqueline Esthappan, Perry W. Grigsby, J. William Harbour

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Purpose To assess the impact on local tumor control of intraoperative ultrasonographic plaque visualization and selective application of transpupillary thermotherapy (TTT) in the treatment of posterior uveal melanoma with iodine-125 (I-125) episcleral plaque brachytherapy (EPB). Methods and Materials Retrospective analysis of 526 patients treated with I-125 EPB for posterior uveal melanoma. Clinical features, dosimetric parameters, TTT treatments, and local tumor control outcomes were recorded. Statistical analysis was performed using Cox proportional hazards and Kaplan-Meier life table method. Results The study included 270 men (51%) and 256 women (49%), with a median age of 63 years (mean, 62 years; range, 16-91 years). Median dose to the tumor apex was 94.4 Gy (mean, 97.8; range, 43.9-183.9) and to the tumor base was 257.9 Gy (mean, 275.6; range, 124.2-729.8). Plaque tilt >1 mm away from the sclera at plaque removal was detected in 142 cases (27%). Supplemental TTT was performed in 72 patients (13.7%). One or 2 TTT sessions were required in 71 TTT cases (98.6%). After a median follow-up of 45.9 months (mean, 53.4 months; range, 6-175 months), local tumor recurrence was detected in 19 patients (3.6%). Local tumor recurrence was associated with lower dose to the tumor base (P=.02). Conclusions Ultrasound-guided plaque localization of I-125 EPB is associated with excellent local tumor control. Detection of plaque tilt by ultrasonography at plaque removal allows supplemental TTT to be used in patients at potentially higher risk for local recurrence while sparing the majority of patients who are at low risk. Most patients require only 1 or 2 TTT sessions.

Original languageEnglish (US)
Pages (from-to)801-805
Number of pages5
JournalInternational Journal of Radiation Oncology Biology Physics
Volume88
Issue number4
DOIs
StatePublished - Mar 15 2014
Externally publishedYes

Fingerprint

iodine 125
Induced Hyperthermia
Brachytherapy
Iodine
Ultrasonography
tumors
Neoplasms
Recurrence
dosage
Sclera
Life Tables
Uveal melanoma
statistical analysis
hazards
apexes

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Outcomes of iodine-125 plaque brachytherapy for uveal melanoma with intraoperative ultrasonography and supplemental transpupillary thermotherapy. / Badiyan, Shahed N.; Rao, Rajesh C.; Apicelli, Anthony J.; Acharya, Sahaja; Verma, Vivek; Garsa, Adam A.; DeWees, Todd; Speirs, Christina K.; Garcia-Ramirez, Jose; Esthappan, Jacqueline; Grigsby, Perry W.; Harbour, J. William.

In: International Journal of Radiation Oncology Biology Physics, Vol. 88, No. 4, 15.03.2014, p. 801-805.

Research output: Contribution to journalArticle

Badiyan, SN, Rao, RC, Apicelli, AJ, Acharya, S, Verma, V, Garsa, AA, DeWees, T, Speirs, CK, Garcia-Ramirez, J, Esthappan, J, Grigsby, PW & Harbour, JW 2014, 'Outcomes of iodine-125 plaque brachytherapy for uveal melanoma with intraoperative ultrasonography and supplemental transpupillary thermotherapy', International Journal of Radiation Oncology Biology Physics, vol. 88, no. 4, pp. 801-805. https://doi.org/10.1016/j.ijrobp.2013.12.014
Badiyan, Shahed N. ; Rao, Rajesh C. ; Apicelli, Anthony J. ; Acharya, Sahaja ; Verma, Vivek ; Garsa, Adam A. ; DeWees, Todd ; Speirs, Christina K. ; Garcia-Ramirez, Jose ; Esthappan, Jacqueline ; Grigsby, Perry W. ; Harbour, J. William. / Outcomes of iodine-125 plaque brachytherapy for uveal melanoma with intraoperative ultrasonography and supplemental transpupillary thermotherapy. In: International Journal of Radiation Oncology Biology Physics. 2014 ; Vol. 88, No. 4. pp. 801-805.
@article{87615765d1814d54a3eca79bfcb323ea,
title = "Outcomes of iodine-125 plaque brachytherapy for uveal melanoma with intraoperative ultrasonography and supplemental transpupillary thermotherapy",
abstract = "Purpose To assess the impact on local tumor control of intraoperative ultrasonographic plaque visualization and selective application of transpupillary thermotherapy (TTT) in the treatment of posterior uveal melanoma with iodine-125 (I-125) episcleral plaque brachytherapy (EPB). Methods and Materials Retrospective analysis of 526 patients treated with I-125 EPB for posterior uveal melanoma. Clinical features, dosimetric parameters, TTT treatments, and local tumor control outcomes were recorded. Statistical analysis was performed using Cox proportional hazards and Kaplan-Meier life table method. Results The study included 270 men (51{\%}) and 256 women (49{\%}), with a median age of 63 years (mean, 62 years; range, 16-91 years). Median dose to the tumor apex was 94.4 Gy (mean, 97.8; range, 43.9-183.9) and to the tumor base was 257.9 Gy (mean, 275.6; range, 124.2-729.8). Plaque tilt >1 mm away from the sclera at plaque removal was detected in 142 cases (27{\%}). Supplemental TTT was performed in 72 patients (13.7{\%}). One or 2 TTT sessions were required in 71 TTT cases (98.6{\%}). After a median follow-up of 45.9 months (mean, 53.4 months; range, 6-175 months), local tumor recurrence was detected in 19 patients (3.6{\%}). Local tumor recurrence was associated with lower dose to the tumor base (P=.02). Conclusions Ultrasound-guided plaque localization of I-125 EPB is associated with excellent local tumor control. Detection of plaque tilt by ultrasonography at plaque removal allows supplemental TTT to be used in patients at potentially higher risk for local recurrence while sparing the majority of patients who are at low risk. Most patients require only 1 or 2 TTT sessions.",
author = "Badiyan, {Shahed N.} and Rao, {Rajesh C.} and Apicelli, {Anthony J.} and Sahaja Acharya and Vivek Verma and Garsa, {Adam A.} and Todd DeWees and Speirs, {Christina K.} and Jose Garcia-Ramirez and Jacqueline Esthappan and Grigsby, {Perry W.} and Harbour, {J. William}",
year = "2014",
month = "3",
day = "15",
doi = "10.1016/j.ijrobp.2013.12.014",
language = "English (US)",
volume = "88",
pages = "801--805",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Outcomes of iodine-125 plaque brachytherapy for uveal melanoma with intraoperative ultrasonography and supplemental transpupillary thermotherapy

AU - Badiyan, Shahed N.

AU - Rao, Rajesh C.

AU - Apicelli, Anthony J.

AU - Acharya, Sahaja

AU - Verma, Vivek

AU - Garsa, Adam A.

AU - DeWees, Todd

AU - Speirs, Christina K.

AU - Garcia-Ramirez, Jose

AU - Esthappan, Jacqueline

AU - Grigsby, Perry W.

AU - Harbour, J. William

PY - 2014/3/15

Y1 - 2014/3/15

N2 - Purpose To assess the impact on local tumor control of intraoperative ultrasonographic plaque visualization and selective application of transpupillary thermotherapy (TTT) in the treatment of posterior uveal melanoma with iodine-125 (I-125) episcleral plaque brachytherapy (EPB). Methods and Materials Retrospective analysis of 526 patients treated with I-125 EPB for posterior uveal melanoma. Clinical features, dosimetric parameters, TTT treatments, and local tumor control outcomes were recorded. Statistical analysis was performed using Cox proportional hazards and Kaplan-Meier life table method. Results The study included 270 men (51%) and 256 women (49%), with a median age of 63 years (mean, 62 years; range, 16-91 years). Median dose to the tumor apex was 94.4 Gy (mean, 97.8; range, 43.9-183.9) and to the tumor base was 257.9 Gy (mean, 275.6; range, 124.2-729.8). Plaque tilt >1 mm away from the sclera at plaque removal was detected in 142 cases (27%). Supplemental TTT was performed in 72 patients (13.7%). One or 2 TTT sessions were required in 71 TTT cases (98.6%). After a median follow-up of 45.9 months (mean, 53.4 months; range, 6-175 months), local tumor recurrence was detected in 19 patients (3.6%). Local tumor recurrence was associated with lower dose to the tumor base (P=.02). Conclusions Ultrasound-guided plaque localization of I-125 EPB is associated with excellent local tumor control. Detection of plaque tilt by ultrasonography at plaque removal allows supplemental TTT to be used in patients at potentially higher risk for local recurrence while sparing the majority of patients who are at low risk. Most patients require only 1 or 2 TTT sessions.

AB - Purpose To assess the impact on local tumor control of intraoperative ultrasonographic plaque visualization and selective application of transpupillary thermotherapy (TTT) in the treatment of posterior uveal melanoma with iodine-125 (I-125) episcleral plaque brachytherapy (EPB). Methods and Materials Retrospective analysis of 526 patients treated with I-125 EPB for posterior uveal melanoma. Clinical features, dosimetric parameters, TTT treatments, and local tumor control outcomes were recorded. Statistical analysis was performed using Cox proportional hazards and Kaplan-Meier life table method. Results The study included 270 men (51%) and 256 women (49%), with a median age of 63 years (mean, 62 years; range, 16-91 years). Median dose to the tumor apex was 94.4 Gy (mean, 97.8; range, 43.9-183.9) and to the tumor base was 257.9 Gy (mean, 275.6; range, 124.2-729.8). Plaque tilt >1 mm away from the sclera at plaque removal was detected in 142 cases (27%). Supplemental TTT was performed in 72 patients (13.7%). One or 2 TTT sessions were required in 71 TTT cases (98.6%). After a median follow-up of 45.9 months (mean, 53.4 months; range, 6-175 months), local tumor recurrence was detected in 19 patients (3.6%). Local tumor recurrence was associated with lower dose to the tumor base (P=.02). Conclusions Ultrasound-guided plaque localization of I-125 EPB is associated with excellent local tumor control. Detection of plaque tilt by ultrasonography at plaque removal allows supplemental TTT to be used in patients at potentially higher risk for local recurrence while sparing the majority of patients who are at low risk. Most patients require only 1 or 2 TTT sessions.

UR - http://www.scopus.com/inward/record.url?scp=84896713543&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896713543&partnerID=8YFLogxK

U2 - 10.1016/j.ijrobp.2013.12.014

DO - 10.1016/j.ijrobp.2013.12.014

M3 - Article

C2 - 24462385

AN - SCOPUS:84896713543

VL - 88

SP - 801

EP - 805

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 4

ER -