%0 Journal Article
%T Outcomes and Control Rates for I-125 Plaque Brachytherapy for Uveal Melanoma: A Community-Based Institutional Experience
%A Aaron Wagner
%A Andy Chen
%A Taylor Cook
%A David Faber
%A Kirk Winward
%A William Sause
%J ISRN Ophthalmology
%D 2014
%R 10.1155/2014/950975
%X 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 ). 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. 1. Introduction Uveal melanoma is an uncommon cancer, with age-adjusted incidence rates of 4.3 new cases per million [1]. Mortality however is not rare, with metastases present in up to 20每39% of patients at 20 years, and tumor related death ranging from 17每20% at 20 years [2]. There have been multiple investigations into appropriate treatment options, and current accepted standards range from observation to enucleation, all dependent on the size and characteristics of the tumor [3每5]. Brachytherapy is frequently utilized for medium sized tumors (apical height 3每10ˋmm and basal diameter 5每16ˋmm) and has been shown to be equivalent to enucleation for tumors in this category [3]. Treatment delivery is nevertheless quite complex, and it has been recommended to only undertake this treatment approach at medical centers with the appropriate expertise [6]. Accordingly, recommendations have been made by the American Brachytherapy Society regarding appropriate treatment delivery and planning [6]. While the efficacy of plaque brachytherapy has been well established in large institutional practices that are well versed in its implementation [7每9], smaller
%U http://www.hindawi.com/journals/isrn.ophthalmology/2014/950975/