TY - JOUR
T1 - Extrascleral extension of choroidal melanoma
T2 - Post-enucleation high-dose-rate interstitial brachytherapy of the orbit
AU - Finger, Paul T.
AU - Tena, Lawrence B.
AU - Semenova, Ekaterina
AU - Aridgides, Paul
AU - Choi, Walter H.
N1 - Funding Information:
Financial disclosure: This work was supported by The Eye Cancer Foundation, Inc. ( http://eyecancerfoundation.net ).
PY - 2014/5
Y1 - 2014/5
N2 - Purpose: To investigate if orbital extension of uveal melanoma can be treated with high-dose-rate (HDR) brachytherapy. Methods and Materials: This study is a retrospective analysis of the results of a clinical case series was performed on 10 patients. Each underwent primary enucleation for uveal melanoma, was discovered to have orbital extension, and consented for HDR brachytherapy. By American Joint Committee on Cancer (AJCC) initial tumor grading, there was one each (T1c, T2c, T2d, and T3d, three T4c, and two T4d-staged uveal melanomas. One was AJCC-staged R2 due to orbital recurrence presenting 16months after enucleation. 192Ir HDR brachytherapy involved transcutaneous circumferential orbital incisions allowing for evenly spaced brachytherapy catheters into the orbit. A target dose of 32.85Gy (range, 32.85-34Gy) was delivered in 9-10 twice-daily fractions (range, 3.4-3.65Gy per fraction) over 5 consecutive days. Data analysis included but was not limited to radiation therapy methods, local tumor control, side effects, and metastatic rate. Results: In the 9 patients who tolerated treatment, there has been no orbital recurrence at a median follow-up of 18months (range, 1-62months). Four patients died of metastatic disease (one presented with a treated solitary liver metastasis before brachytherapy). There was no significant eyelash or eyebrow loss. There was no radiation-induced eyelid erythema, orbital infection, or contracted sockets. All orbits accepted and maintained ocular prostheses. Conclusions: Brachytherapy was used as an alternative to external beam radiation treatment for postenucleation orbital melanoma. This series reports complete local control, few side effects, and excellent cosmetic results.
AB - Purpose: To investigate if orbital extension of uveal melanoma can be treated with high-dose-rate (HDR) brachytherapy. Methods and Materials: This study is a retrospective analysis of the results of a clinical case series was performed on 10 patients. Each underwent primary enucleation for uveal melanoma, was discovered to have orbital extension, and consented for HDR brachytherapy. By American Joint Committee on Cancer (AJCC) initial tumor grading, there was one each (T1c, T2c, T2d, and T3d, three T4c, and two T4d-staged uveal melanomas. One was AJCC-staged R2 due to orbital recurrence presenting 16months after enucleation. 192Ir HDR brachytherapy involved transcutaneous circumferential orbital incisions allowing for evenly spaced brachytherapy catheters into the orbit. A target dose of 32.85Gy (range, 32.85-34Gy) was delivered in 9-10 twice-daily fractions (range, 3.4-3.65Gy per fraction) over 5 consecutive days. Data analysis included but was not limited to radiation therapy methods, local tumor control, side effects, and metastatic rate. Results: In the 9 patients who tolerated treatment, there has been no orbital recurrence at a median follow-up of 18months (range, 1-62months). Four patients died of metastatic disease (one presented with a treated solitary liver metastasis before brachytherapy). There was no significant eyelash or eyebrow loss. There was no radiation-induced eyelid erythema, orbital infection, or contracted sockets. All orbits accepted and maintained ocular prostheses. Conclusions: Brachytherapy was used as an alternative to external beam radiation treatment for postenucleation orbital melanoma. This series reports complete local control, few side effects, and excellent cosmetic results.
KW - Brachytherapy
KW - Extrascleral
KW - Melanoma
KW - Orbit
KW - Radiation
UR - http://www.scopus.com/inward/record.url?scp=84899978578&partnerID=8YFLogxK
U2 - 10.1016/j.brachy.2013.09.002
DO - 10.1016/j.brachy.2013.09.002
M3 - Article
C2 - 24139892
AN - SCOPUS:84899978578
SN - 1538-4721
VL - 13
SP - 275
EP - 280
JO - Brachytherapy
JF - Brachytherapy
IS - 3
ER -