ArticleRadiation oncology (London, England)2025
Anatomical outcome after brachytherapy with bi-nuclide (Ru-106/Iodine-125) plaques in large uveal melanomas.
Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundProprietary bi-nuclide plaques combine the radiation properties of beta and gamma brachytherapy and can irradiate a larger target volume compared to ruthenium-plaques. While reducing the dose to structures outside the target volume, brachytherapy with bi-nuclide-plaques (BBNP) delivers a higher target dose compared to iodine-plaques. We aimed at analyzing the local tumor control and eye retention probability after BBNP.
methodsAll consecutive cases with large uveal melanoma (tumor thickness ≥ 7 mm) treated with BBNP at our institution between 01/1999 and 12/2020 were included (n = 576, median follow-up: 30.8 months [interquartile range, IQR: 12.9-57.4]). Univariable and multivariable Cox regression analyses were performed.
resultsSecondary enucleation (SE) was performed in 13.5% of cases (n = 78) after the median of 20.0 months (IQR: 9.0-34.7) post-BBNP. The overall rate of local tumor recurrence (LR) in the cohort was 8.5% (n = 49) and was diagnosed at the median post-BBNP interval of 20.0 months (IQR: 15.6-35.2). Of the patients' baseline characteristics, higher age (> 67 years, adjusted hazard ratio [aHR] = 1.80, p = 0.011), tumor thickness (> 8.5 mm, aHR = 2.20, p = 0.002), visual acuity (> 0.5 logMAR, aHR = 1.83, p = 0.009), and sclera dose (> 1000 Gy, aHR = 1.65, p = 0.034) were independently associated with the risk of SE. In turn, higher age (> 67 years, aHR = 1.93, p = 0.023), tumor thickness (> 8.5 mm, aHR = 2.02, p = 0.020), and visual acuity (> 0.5 logMAR, aHR = 2.27, p = 0.005) were independently related to LR.
conclusionsBBNP facilitates eye retention in 86.5% of patients with large uveal melanoma 2.5 years after treatment. Patients' baseline, tumor and treatment characteristics were strongly associated with the risk of SE and LR after BBNP.
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