Low dose iodine-125 brachytherapy and transpupillary thermal therapy for small- to medium-sized choroidal melanoma

IF 1.8 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2026-03-01 Epub Date: 2025-12-16 DOI:10.1016/j.brachy.2025.11.011

S Fattahi , CL Deufel , KV Astafurov , TW Olsen , SL Stafford , MA Neben Wittich , WS Harmsen , JK Viehman , LA Dalvin , IA Petersen , KS Corbin

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引用次数: 0

Abstract

PURPOSE

COMS established iodine-125 (¹²⁵I) brachytherapy as standard of care for medium-sized choroidal melanomas. However, there remains a gap in the literature regarding reduced dosing for medium-sized choroidal melanomas and standard dosing for small-sized choroidal melanomas. We explored the impact of reduced dose ¹²⁵I brachytherapy on local tumor control and ocular adverse events (AEs).

METHODS

Patients diagnosed 2005–2019 with choroidal melanoma <5 mm thick and managed with ¹²⁵I brachytherapy dose of 65 Gy to depth of 5 mm were included. Dose metrics were calculated using Monte Carlo-based dosimetry. Kaplan-Meier method was used to estimate overall survival and radiation-related AEs. Distant metastasis and local recurrence were reported using cumulative incidence with death as a competing risk. Univariate and multivariate associations were analyzed using Cox proportional hazards regression.

RESULTS

143 patients met inclusion criteria with median follow-up of 7 years. Five-year Kaplan-Meier estimates of ocular AEs were 59.6% radiation maculopathy, 42.0% cystoid macular edema, 55.2% nonproliferative radiation retinopathy, 10.8% proliferative radiation retinopathy, and 35.6% radiation papillopathy. Five-year cumulative incidence of local recurrence was 0%, 5-year cumulative incidence of distant metastasis was 6.1%, and 5-year Kaplan-Meier estimate of overall survival was 96.5%.

CONCLUSION

Reduced dose ¹²⁵I brachytherapy is feasible with excellent local tumor control.

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小剂量碘-125近距离治疗和上乳头热治疗中小脉络膜黑色素瘤。

目的：COMS建立碘-125 （125I）近距离放疗作为中等脉络膜黑色素瘤的标准治疗。然而，关于中型脉络膜黑色素瘤的减少剂量和小型脉络膜黑色素瘤的标准剂量，文献中仍然存在空白。我们探讨了低剂量125I近距离放疗对局部肿瘤控制和眼部不良事件（ae）的影响。方法：纳入2005-2019年诊断为脉络膜黑色素瘤的患者，125I近距离放疗剂量为65 Gy，深度为5 mm。剂量计量采用蒙特卡罗剂量法计算。Kaplan-Meier法用于估计总生存率和辐射相关ae。远处转移和局部复发的报道使用累积发病率与死亡作为竞争风险。采用Cox比例风险回归分析单因素和多因素相关性。结果：143例患者符合纳入标准，中位随访7年。五年Kaplan-Meier估计眼部ae为59.6%的放射性黄斑病变，42.0%的囊状黄斑水肿，55.2%的非增殖性放射性视网膜病变，10.8%的增殖性放射性视网膜病变和35.6%的放射性乳头病变。5年累积局部复发发生率为0%，5年累积远处转移发生率为6.1%，5年Kaplan-Meier估计总生存率为96.5%。结论：125I小剂量近距离放疗可行，局部肿瘤控制良好。

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.