A retrospective study on ruthenium-106 and strontium-90 eye-plaques treatment for retinoblastoma: 16-years clinical experience

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2025-03-01 DOI:10.1016/j.brachy.2024.11.008

Andrey A. Yarovoy, Denis P. Volodin, Vera A. Yarovaya

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Abstract

PURPOSE

To retrospectively evaluate the efficacy of plaque brachytherapy for the treatment of retinoblastoma.

METHODS

We retrospectively reviewed the clinical records of 163 patients (186 eyes, 333 tumors) treated with brachytherapy (¹⁰⁶Ru or ⁹⁰Sr plaques) for intraocular retinoblastoma between November 2007 and August 2023.

RESULTS

Complete tumor control was achieved in 273 tumors (82%). Incomplete tumor control was observed in 44 tumors (13%). Thirteen tumors presented with tumor progression. Three tumors relapsed after brachytherapy. On multivariate statistical analysis apex dose ≤ 85 Gy (for ¹⁰⁶Ru) (p = 0.03), dark fundus pigmentation (p = 0.005) and intraarterial chemotherapy-brachytherapy period < 2 months (p = 0.001) demonstrated significant effect on brachytherapy insufficiency.

Radiation-induced complications occurred in 62 eyes (33%). The most frequent complications were nonproliferative retinopathy (n = 39, 21%), optic neuropathy (n = 29, 16%) and vitreous hemorrhage (n = 29, 16%). Multivariate statistical analysis showed central localization (p = 0.005), tumor thickness > 2.7 mm (p = 0.04) and larger plaque diameter (>14 mm) (p = 0.035) to be the most significant variables for brachytherapy-associated complications.

Eye retention was achieved in 91% of the treated eyes (n = 169). 17 eyes (9%) were enucleated. The reasons for enucleation were tumor recurrence or uncontrolled tumor growth (n = 7), anterior chamber involvement (n = 3), recurrent active vitreous seeding (n = 1), inability of adequate tumor monitoring due to opaque media (dense total vitreous hemorrhage or total retinal detachment) (n = 3), subatrophy of the eye with functional blindness (n = 3).

CONCLUSION

Overall, Beta-ray brachytherapy proved to be a highly effective method of retinoblastoma treatment with excellent local tumor control, eye preservation rate and acceptable incidence of curable radiation-induced complications.

查看原文本刊更多论文

钌-106和锶-90眼斑治疗视网膜母细胞瘤的回顾性研究：16年临床经验。

目的：回顾性评价斑块近距离放疗治疗视网膜母细胞瘤的疗效。方法：回顾性分析2007年11月至2023年8月间接受近距离放疗（106Ru或90Sr斑块）治疗眼内视网膜母细胞瘤的163例患者（186只眼，333个肿瘤）的临床资料。结果：273例（82%）肿瘤得到完全控制。44例（13%）肿瘤控制不完全。13例出现肿瘤进展。3例肿瘤近距离治疗后复发。多因素统计分析显示，顶点剂量≤85 Gy (106Ru) （p = 0.03）、眼底色素沉着（p = 0.005）和动脉内化疗-近距离治疗时间< 2个月（p = 0.001）对近距离治疗不全有显著影响。62只眼（33%）发生放射性并发症。最常见的并发症为非增殖性视网膜病变（n = 39.21%）、视神经病变（n = 29.16%）和玻璃体出血（n = 29.16%）。多因素统计分析显示，中心定位（p = 0.005）、肿瘤厚度> 2.7 mm （p = 0.04）和斑块直径较大（>14 mm）（p = 0.035）是近距离治疗相关并发症的最显著变量。91%的治疗眼实现眼潴留（n = 169）。17眼（9%）去核。摘出术的原因是肿瘤复发或控制肿瘤生长(n = 7),前房参与(n = 3),复发性活跃的玻璃播种(n = 1),不能足够的肿瘤监测由于不透明的媒体(密集的玻璃体出血或视网膜脱离全)(n = 3),subatrophy功能性失明的眼睛(n = 3)。结论：总的来说，β射线近距离治疗视网膜母细胞瘤是一种非常有效的治疗方法，具有良好的局部肿瘤控制，眼睛保存率和可治愈的放射并发症发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.