Ophthalmic applicator displacement as a method of treating large diffuse uveal melanomas

Anna Markiewicz; Konrad Skórkiewicz; Agata Bogdał; Dominik Medoń; Mirella Świder; Elżbieta Korab-Chrzanowska; Joanna Kowal; Magdalena Dębicka-Kumela; Bożena Romanowska-Dixon

doi:10.5114/jcb.2023.128920

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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3/2023
vol. 15

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abstract:

Original paper

Ophthalmic applicator displacement as a method of treating large diffuse uveal melanomas

Anna Markiewicz

^{1, 2}

,

Konrad Skórkiewicz

^{3, 4, 5}

,

Agata Bogdał

^{3, 4}

,

Dominik Medoń

³

,

Mirella Świder

³

,

Elżbieta Korab-Chrzanowska

²

,

Joanna Kowal

^{1, 2}

,

Magdalena Dębicka-Kumela

^{1, 2}

,

Bożena Romanowska-Dixon

^{1, 2}

Department of Ophthalmology and Ocular Oncology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
Department of Ophthalmology and Ocular Oncology, University Hospital, Krakow, Poland
Department of Medical Physics and Radiation Protection, University Hospital, Krakow, Poland
Department of Medical Physics, Faculty of Physics, Astronomy, and Applied Computer Science, Jagiellonian University, Kraków, Poland
Department of Physiology, Faculty of Biophysics, Jagiellonian University Medical College, Krakow, Poland

J Contemp Brachytherapy 2023; 15, 3: 184–190

DOI: https://doi.org/10.5114/jcb.2023.128920

Online publish date: 2023/06/26

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Purpose:
The presentation of results of an ophthalmic plaque displacement as a brachytherapy treatment method of large diffuse uveal melanomas.

Material and methods:
This was a retrospective analysis of treatment results of 9 patients with large diffuse uveal melanomas using ophthalmic plaque displacement. Patients were treated with this method in our center between 2012 and 2021 (last follow-up visit in 2023). To achieve appropriate radiation dose distribution for large tumors with a base greater than 18 mm, brachytherapy (¹⁰⁶Ru in 7 patients and ¹²⁵I in 2 patients) with applicator displacement was used as primary treatment. Median follow-up was 2.9 years, and for patients with positive primary treatment results, it was 1.7 months. Median time to local relapse was 2.3 years.

Results:
In 5 patients, a positive result of local treatment was obtained, out of whom, one patient underwent enucleation due to complications. In the next 4 cases, local recurrence developed. In all tumors, the use of applicator displacement method caused that planning target volume (PTV) was effectively covered with treatment isodose.

Conclusions:
Brachytherapy with ocular applicator displacement allows for the treatment of tumors with base measurements larger than 18 mm. The application of this method may be considered as an alternative for eye enucleation in particular cases of large diffuse tumors, such as a neoplasm of the eye with vison, or when a patient does not consent to enucleation.

keywords:

uveal melanoma, applicator displacement, plaque displacement, brachytherapy, enucleation, ocular melanoma, diffuse uveal melanoma, ophthalmic applicator

Ophthalmic applicator displacement as a method of treating large diffuse uveal melanomas

Anna Markiewicz 1, 2 , Konrad Skórkiewicz 3, 4, 5 , Agata Bogdał 3, 4 , Dominik Medoń 3 , Mirella Świder 3 , Elżbieta Korab-Chrzanowska 2 , Joanna Kowal 1, 2 , Magdalena Dębicka-Kumela 1, 2 , Bożena Romanowska-Dixon 1, 2

uveal melanoma, applicator displacement, plaque displacement, brachytherapy, enucleation, ocular melanoma, diffuse uveal melanoma, ophthalmic applicator

Anna Markiewicz

^{1, 2}

,

Konrad Skórkiewicz

^{3, 4, 5}

,

Agata Bogdał

^{3, 4}

,

Dominik Medoń

³

,

Mirella Świder

³

,

Elżbieta Korab-Chrzanowska

²

,

Joanna Kowal

^{1, 2}

,

Magdalena Dębicka-Kumela

^{1, 2}

,

Bożena Romanowska-Dixon

^{1, 2}