Tilting of radioactive plaques after initial accurate placement for treatment of uveal melanoma

Archives of Ophthalmology
Arghavan AlmonyJ William Harbour

Abstract

To evaluate plaque movement as a potential factor in local failure using intraoperative ultrasonography at plaque insertion and removal. Prospective study of 162 patients with uveal melanoma undergoing intraoperative B-scan ultrasonography at insertion and removal of iodine 125 plaques. Tilting of the posterior plaque edge more than 1.0 mm away from the sclera was detected in 15 patients (9%) at plaque insertion and in 85 patients (53%) at plaque removal (P < .001). Factors associated with tilt at plaque removal included male sex (P = .009), decreased tumor distance to the fovea and optic disc (P < .001 for both), notched plaque (P = .001), and episcleral hematoma (P = .009). Plaque tilt caused a reduction greater than 10% in actual radiation dose to the tumor apex in 37 patients (23%). Local failure occurred in only 3 patients (2%), all of whom had tilt of 1.95 mm or greater at plaque removal. Plaque tilt after initial accurate placement occurs frequently during brachytherapy for uveal melanomas and may represent an important cause of local treatment failure. Recognizing and counteracting the effects of plaque tilt may reduce the risk of local failure. clinicaltrials.gov Identifier: NCT00459849.

Citations

Jan 28, 2014·International Journal of Radiation Oncology, Biology, Physics·Shahed N BadiyanJ William Harbour
Feb 16, 2016·Ophthalmic Surgery, Lasers & Imaging Retina·Ofira ZlotoIdo Didi Fabian
Feb 20, 2014·American Journal of Ophthalmology·Aline I RiechardtAntonia M Joussen
Jun 27, 2015·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Ofira ZlotoIdo Didi Fabian
Jul 20, 2014·American Journal of Ophthalmology·Aline I RiechardtAntonia M Joussen
Mar 13, 2014·International Journal of Radiation Oncology, Biology, Physics·Bradford A PerezDavid G Kirsch
Aug 5, 2016·Medical Physics·Hali MorrisonRon S Sloboda
Feb 6, 2017·The British Journal of Ophthalmology·Charlotte Alfast EspensenJens Folke Kiilgaard
Mar 1, 2016·Melanoma Management·Patrick Oellers, Prithvi Mruthyunjaya
Oct 16, 2018·Ocular Oncology and Pathology·Erik StöckelWolfgang Sauerwein
Aug 19, 2017·Brachytherapy·Jacqueline Esthappan ZoberiPerry W Grigsby
Jul 2, 2021·Brachytherapy·Matthew T StudenskiJ William Harbour
Sep 17, 2021·European Journal of Ophthalmology·Anthony FamPaul T Finger

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