Skip to main content
Erschienen in: Strahlentherapie und Onkologie 11/2023

06.06.2023 | Case Study

Brachytherapy in the prevention of recurrence of conjunctival melanoma

Results of a case report in a University Hospital in Valladolid, Spain

verfasst von: Gabriela Estefanía Pacheco-Callirgos, Ciro García-Alvarez, Luis Garcia-Onrubia, David Miguel-Pérez, Pilar Alonso-Martinez, Patricia Diezhandino, Jesus Maria de Frutos Barajas, Maria Antonia Saornil-Alvarez

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 11/2023

Einloggen, um Zugang zu erhalten

Abstract

Aim

Describe the results of brachytherapy in the prevention of recurrences in conjunctival melanoma (CM) and describe a dosimetric protocol.

Methods

Retrospective and descriptive case report. Eleven consecutive patients with a confirmed histopathological diagnosis of CM treated with brachytherapy between 1992 and 2023 were reviewed. Demographic, clinical, and dosimetric characteristics as well as recurrences were recorded. Quantitative variables were represented by the mean, median, and standard deviation, and qualitative variables by frequency of distribution.

Results

Of a total of 27 patients diagnosed with CM, 11 who were treated with brachytherapy were included in the study (7 female; mean age at time of treatment: 59.4 years). Mean follow-up was 58.82 months (range 11–141 months). Of a total of 11 patients, 8 were treated with ruthenium-106 and 3 with iodine-125. Brachytherapy was performed in 6 patients as adjuvant therapy after biopsy-proven CM on histopathology and in the other 5 patients after recurrence. The mean dose was 85 Gy in all cases. Recurrences outside of the previously irradiated area were observed in 3 patients, metastases were diagnosed in 2 patients, and one case of an ocular adverse event was reported.

Conclusion

Brachytherapy is an adjuvant treatment option in invasive conjunctival melanoma. In our case report, only one patient had an adverse effect. However, this topic requires further research. Furthermore, each case is unique and should be evaluated by experts in a multidisciplinary approach involving ophthalmologists, radiation oncologists, and physicists.
Literatur
1.
Zurück zum Zitat McLaughlin CC, Wu X‑C, Jemal A et al (2005) Incidence of noncutaneous melanomas in the U.S. Cancer 103:1000–1007CrossRefPubMed McLaughlin CC, Wu X‑C, Jemal A et al (2005) Incidence of noncutaneous melanomas in the U.S. Cancer 103:1000–1007CrossRefPubMed
2.
Zurück zum Zitat Isager P, Østerlind A, Engholm G et al (2005) Uveal and conjunctival malignant melanoma in Denmark, 1943–97: incidence and validation study. Ophthalmic Epidemiol 1:223–232CrossRef Isager P, Østerlind A, Engholm G et al (2005) Uveal and conjunctival malignant melanoma in Denmark, 1943–97: incidence and validation study. Ophthalmic Epidemiol 1:223–232CrossRef
3.
Zurück zum Zitat Mahendraraj K, Shrestha S, Lau CS et al (2017) Ocular melanoma-when you have seen one, you have not seen them all: a clinical outcome study from the Surveillance, Epidemiology and End Results (SEER) database (1973–2012). Clin Ophthalmol 11:153–160CrossRefPubMedPubMedCentral Mahendraraj K, Shrestha S, Lau CS et al (2017) Ocular melanoma-when you have seen one, you have not seen them all: a clinical outcome study from the Surveillance, Epidemiology and End Results (SEER) database (1973–2012). Clin Ophthalmol 11:153–160CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Saornil MA, Becerra E, Méndez MC et al (2009) Tumores de la conjuntiva. Arch La Soc Española Oftalmol 84:7–22 Saornil MA, Becerra E, Méndez MC et al (2009) Tumores de la conjuntiva. Arch La Soc Española Oftalmol 84:7–22
5.
Zurück zum Zitat Shields CL, Markowitz JS, Belinsky I et al (2011) Conjunctival melanoma: outcomes based on tumor origin in 382 consecutive cases. Ophthalmology 118:389–395CrossRefPubMed Shields CL, Markowitz JS, Belinsky I et al (2011) Conjunctival melanoma: outcomes based on tumor origin in 382 consecutive cases. Ophthalmology 118:389–395CrossRefPubMed
6.
Zurück zum Zitat Cohen VML, O’Day RF (2019) Management issues in conjunctival tumours: conjunctival melanoma and primary acquired melanosis. Ophthalmol Ther 8:501–510CrossRefPubMedPubMedCentral Cohen VML, O’Day RF (2019) Management issues in conjunctival tumours: conjunctival melanoma and primary acquired melanosis. Ophthalmol Ther 8:501–510CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Shields CL (2000) Conjunctival melanoma: risk factors for recurrence, exenteration, metastasis, and death in 150 consecutive patients. Trans Am Ophthalmol Soc 98:471–492PubMedPubMedCentral Shields CL (2000) Conjunctival melanoma: risk factors for recurrence, exenteration, metastasis, and death in 150 consecutive patients. Trans Am Ophthalmol Soc 98:471–492PubMedPubMedCentral
8.
Zurück zum Zitat Kao A, Afshar A, Bloomer M et al (2016) Management of primary acquired melanosis, nevus, and conjunctival melanoma. Cancer Control 23:117–125CrossRefPubMed Kao A, Afshar A, Bloomer M et al (2016) Management of primary acquired melanosis, nevus, and conjunctival melanoma. Cancer Control 23:117–125CrossRefPubMed
9.
Zurück zum Zitat Shields CL, Shields JA, Gündüz K et al (2000) Conjunctival melanoma; risk factors for recurrence, exenteration, metastasis, and death in 150 consecutive patients. Arch Ophthalmol 118:1497–1507CrossRefPubMed Shields CL, Shields JA, Gündüz K et al (2000) Conjunctival melanoma; risk factors for recurrence, exenteration, metastasis, and death in 150 consecutive patients. Arch Ophthalmol 118:1497–1507CrossRefPubMed
10.
Zurück zum Zitat Damato B, Coupland SE (2009) Management of conjunctival melanoma. Expert Rev Anticancer Ther 9:1227–1239CrossRefPubMed Damato B, Coupland SE (2009) Management of conjunctival melanoma. Expert Rev Anticancer Ther 9:1227–1239CrossRefPubMed
11.
Zurück zum Zitat Pacheco G, Garcia-Onrubia L, Garcia-Alvarez C et al (2019) A retrospective review of conjuctival melanoma: Presentation, treatment and evolución. Arch Soc Esp Oftalmolol 94:218–224CrossRef Pacheco G, Garcia-Onrubia L, Garcia-Alvarez C et al (2019) A retrospective review of conjuctival melanoma: Presentation, treatment and evolución. Arch Soc Esp Oftalmolol 94:218–224CrossRef
12.
Zurück zum Zitat Brouwer NJ, Marinkovic M, van Duinen SG et al (2018) Treatment of conjunctival melanoma in a Dutch referral centre. Br J Ophthalmol 102:1277–1282CrossRefPubMed Brouwer NJ, Marinkovic M, van Duinen SG et al (2018) Treatment of conjunctival melanoma in a Dutch referral centre. Br J Ophthalmol 102:1277–1282CrossRefPubMed
13.
Zurück zum Zitat Tagliaferri L, Pagliara MM, Boldrini L et al (2017) INTERACTS (INTErventional Radiotherapy ACtive Teaching School) guidelines for quality assurance in choroidal melanoma interventional radiotherapy (brachytherapy) procedures. J Contemp Brachytherapy 9:287–295CrossRefPubMedPubMedCentral Tagliaferri L, Pagliara MM, Boldrini L et al (2017) INTERACTS (INTErventional Radiotherapy ACtive Teaching School) guidelines for quality assurance in choroidal melanoma interventional radiotherapy (brachytherapy) procedures. J Contemp Brachytherapy 9:287–295CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Simpson ER, Gallie B, Laperrierre N (2014) The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma. Brachytherapy 13:1–14CrossRef Simpson ER, Gallie B, Laperrierre N (2014) The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma. Brachytherapy 13:1–14CrossRef
15.
Zurück zum Zitat ICRU (2014) International Commission on Radiation Units and Measurements. ICRU Report No. 72: Dosimetry of beta rays and low-energy photons for brachytherapy with sealed sources. J ICRU 4:2–175 ICRU (2014) International Commission on Radiation Units and Measurements. ICRU Report No. 72: Dosimetry of beta rays and low-energy photons for brachytherapy with sealed sources. J ICRU 4:2–175
16.
Zurück zum Zitat Nag S, Quivey JM, Earle JD et al (2003) The American Brachytherapy Society recommendations for brachytherapy of uveal melanomas. Int J Radiat Oncol Biol Phys 56:544–555CrossRefPubMed Nag S, Quivey JM, Earle JD et al (2003) The American Brachytherapy Society recommendations for brachytherapy of uveal melanomas. Int J Radiat Oncol Biol Phys 56:544–555CrossRefPubMed
17.
Zurück zum Zitat Simpson ER, Gallie B, Laperrierre N (2014) The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma. Brachytherapy 131:1–14CrossRef Simpson ER, Gallie B, Laperrierre N (2014) The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma. Brachytherapy 131:1–14CrossRef
18.
Zurück zum Zitat Miguel D, de Frutos JM, López-Lara F et al (2019) Treatment planning considerations for 125I eye plaque brachytherapy. J Contemp Brachytherapy 11:280–284CrossRefPubMedPubMedCentral Miguel D, de Frutos JM, López-Lara F et al (2019) Treatment planning considerations for 125I eye plaque brachytherapy. J Contemp Brachytherapy 11:280–284CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat ISO (2009) International Organisation for Standardization. Clinical Dosimetry—Beta Radiation Sources for Brachytherapy. International Organisation for Standardization), Geneva ISO (2009) International Organisation for Standardization. Clinical Dosimetry—Beta Radiation Sources for Brachytherapy. International Organisation for Standardization), Geneva
20.
Zurück zum Zitat Thomson RM, Furutani KM, Kaulich TW et al (2020) AAPM recommendations on medical physics practices for ocular plaque brachytherapy: Report of task group 221. Med Phys 47:92–124CrossRef Thomson RM, Furutani KM, Kaulich TW et al (2020) AAPM recommendations on medical physics practices for ocular plaque brachytherapy: Report of task group 221. Med Phys 47:92–124CrossRef
21.
Zurück zum Zitat Astrahan MA, Luxton G, Jozsef G et al (1990) An interactive treatment planning system for ophthalmic plaque radiotherapy. Int J Radiat Oncol Biol Phys 18:679–687CrossRefPubMed Astrahan MA, Luxton G, Jozsef G et al (1990) An interactive treatment planning system for ophthalmic plaque radiotherapy. Int J Radiat Oncol Biol Phys 18:679–687CrossRefPubMed
22.
Zurück zum Zitat Nath R, Anderson LL, Luxton G et al (1995) Dosimetry of interstitial brachytherapy sources: recommendations of the AAPM Radiation Therapy Committee Task Group No. 43. American Association of Physicists in Medicine. Med Phys 22:209–234CrossRefPubMed Nath R, Anderson LL, Luxton G et al (1995) Dosimetry of interstitial brachytherapy sources: recommendations of the AAPM Radiation Therapy Committee Task Group No. 43. American Association of Physicists in Medicine. Med Phys 22:209–234CrossRefPubMed
23.
Zurück zum Zitat Rivard MJ, Coursey BM, DeWerd LA et al (2004) Update of AAPM Task Group No. 43 Report: A revised AAPM protocol for brachytherapy dose calculations. Med Phys 31:633–674CrossRefPubMed Rivard MJ, Coursey BM, DeWerd LA et al (2004) Update of AAPM Task Group No. 43 Report: A revised AAPM protocol for brachytherapy dose calculations. Med Phys 31:633–674CrossRefPubMed
24.
Zurück zum Zitat Treacher Collins E (1918) Case of epibulbar sarcoma cured by its removal and the application of radium. Trans Ophthal Soc Uk 38:125–127 Treacher Collins E (1918) Case of epibulbar sarcoma cured by its removal and the application of radium. Trans Ophthal Soc Uk 38:125–127
25.
Zurück zum Zitat Lommatzsch PK, Lommatzsch RE, Kirsch I et al (1990) Therapeutic outcome of patients suffering from malignant melanomas of the conjunctiva. Br J Ophthalmol 74:615–619CrossRefPubMedPubMedCentral Lommatzsch PK, Lommatzsch RE, Kirsch I et al (1990) Therapeutic outcome of patients suffering from malignant melanomas of the conjunctiva. Br J Ophthalmol 74:615–619CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Walsh-Conway N, Conway RM (2009) Plaque brachytherapy for the management of ocular surface malignancies with corneoscleral invasion. Clin Exp Ophthalmol 37:577–583CrossRefPubMed Walsh-Conway N, Conway RM (2009) Plaque brachytherapy for the management of ocular surface malignancies with corneoscleral invasion. Clin Exp Ophthalmol 37:577–583CrossRefPubMed
27.
Zurück zum Zitat Karim R, Conway RM (2011) Conservative resection and adjuvant plaque brachytherapy for early stage conjuctival melanoma. Clin Experiment Ophthalmol 39:293–298CrossRefPubMed Karim R, Conway RM (2011) Conservative resection and adjuvant plaque brachytherapy for early stage conjuctival melanoma. Clin Experiment Ophthalmol 39:293–298CrossRefPubMed
28.
Zurück zum Zitat Shields CL, Shields JA (2004) Tumors of the conjunctiva and cornea. Surv Ophthalmol 49:3–24CrossRefPubMed Shields CL, Shields JA (2004) Tumors of the conjunctiva and cornea. Surv Ophthalmol 49:3–24CrossRefPubMed
29.
Zurück zum Zitat Shields CL, Chien JL, Surakiatchanukul T et al (2017) Conjunctival tumors: review of clinical features, risks, biomarkers, and outcomes—the 2017 J. Donald M. Gass lecture. Asia Pac J Ophthalmol 6:109–120 Shields CL, Chien JL, Surakiatchanukul T et al (2017) Conjunctival tumors: review of clinical features, risks, biomarkers, and outcomes—the 2017 J. Donald M. Gass lecture. Asia Pac J Ophthalmol 6:109–120
Metadaten
Titel
Brachytherapy in the prevention of recurrence of conjunctival melanoma
Results of a case report in a University Hospital in Valladolid, Spain
verfasst von
Gabriela Estefanía Pacheco-Callirgos
Ciro García-Alvarez
Luis Garcia-Onrubia
David Miguel-Pérez
Pilar Alonso-Martinez
Patricia Diezhandino
Jesus Maria de Frutos Barajas
Maria Antonia Saornil-Alvarez
Publikationsdatum
06.06.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Strahlentherapie und Onkologie / Ausgabe 11/2023
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-023-02094-6

Weitere Artikel der Ausgabe 11/2023

Strahlentherapie und Onkologie 11/2023 Zur Ausgabe

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Erhöhtes Risiko fürs Herz unter Checkpointhemmer-Therapie

28.05.2024 Nebenwirkungen der Krebstherapie Nachrichten

Kardiotoxische Nebenwirkungen einer Therapie mit Immuncheckpointhemmern mögen selten sein – wenn sie aber auftreten, wird es für Patienten oft lebensgefährlich. Voruntersuchung und Monitoring sind daher obligat.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.