ETD

Digital archive of theses discussed at the University of Pisa

 

Thesis etd-12222021-114139


Thesis type
Tesi di specializzazione (4 anni)
Author
FUENTES, TAIUSHA
URN
etd-12222021-114139
Thesis title
PLAQUE BRACHYTHERAPY FOR THE TREATMENT OF UVEAL MELANOMA: OUR STRATEGIES AND RESULTS
Department
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Course of study
RADIOTERAPIA
Supervisors
relatore Laliscia, Concetta
correlatore Paiar, Fabiola
Keywords
  • Brachytherapy
  • Uveal melanoma
Graduation session start date
11/01/2022
Availability
Withheld
Release date
11/01/2092
Summary
Abstract
AIM: To evaluate our community-based institutional experience of the treatment of uveal melanoma (UM), with plaque brachytherapy using ruthenium-106 and iodine-125 plaques, with a focus on local control rates, factors impacting disease progression, metastasis and enucleation.
Material and Methods: A retrospective study of patients affected by UM from January 2010 to November 2020, using ruthenium-106 and iodine-152 plaques at the University Hospital of Pisa. UM was diagnosticated with A-scan and B-scan standardized echography, fluorescein angiography, indocyanine green–angiography, optical coherence tomography and/or magnetic resonance. Primary outcomes measures were local control, overall survival, progression disease, globe preservation and metastases. Secondary outcome measures were acute and late radiation adverse effects.
Results: A total of 155 patients with UM located in the choroid (75.5%), ciliary body (20%) and the iris (4.5%). Their mean age at the diagnosis was 66 years. The median follow up was 73.5 months (range 12-130 months). The mean thickness at tumor apex was 4.2 mm (SD 2.6), with a mean basal diameter of 9.1 mm (SD 3.4). 86 (55.5%) of the 155 tumors were T-category 1 or 2 according with the American Joint Committee on Cancer (AJCC) classification and 69 (44.5%) were T-size category 3, no T-size categoty 4 were included in this study. 116 patients (74.8%) were treated with 106Ru plaque with a prescription dose of 110 Gy at the tumor apex, the remaining 39 tumors (25.2%) were treated with 125I plaque with a prescription dose of 85 Gy to the tumor apex.
The 5 yea rate of LC, PFS, OS, EFS and MFS were 92.9%, 89%, 96.7%, 96.1% and 94.2% respectively.
The most frequent common terminology criteria for late events grade 1 toxicity was vitreous hemorrhage (8.4%), grade 2 was retinal vascular disorders (9.7%), grade 3 was cataract (25.2%), and grade 4 was glaucoma (1.3%).
Conclusions:
Plaque BT offers an effective and safe approach for selected cases of uveal melanoma, due to the reported satisfactory results in terms of local control, eye conservation and survival.
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