PMID- 28048976
OWN - NLM
STAT- MEDLINE
DCOM- 20170508
LR  - 20220408
IS  - 1879-1891 (Electronic)
IS  - 0002-9394 (Linking)
VI  - 176
DP  - 2017 Apr
TI  - Repeat Episcleral Plaque Brachytherapy: Clinical Outcomes in Patients Treated for 
      Locally Recurrent Posterior Uveal Melanoma.
PG  - 40-45
LID - S0002-9394(16)30629-8 [pii]
LID - 10.1016/j.ajo.2016.12.022 [doi]
AB  - PURPOSE: To report the outcomes of survival, local control, visual acuity, and 
      eye retention in patients treated with repeat episcleral plaque brachytherapy 
      (EPBT) for locally recurrent posterior uveal melanoma (PUM). DESIGN: 
      Retrospective, interventional case series. METHODS: Setting: Institutional. 
      PATIENT POPULATION: A total of 1201 patients that underwent iodine-125 (I-125) 
      EPBT as primary treatment for PUM between 1985 and 2015. INCLUSION CRITERIA: 
      Development of locally recurrent disease and retreatment with I-125 EPBT. 
      OBSERVATION PROCEDURES: Clinical records review. MAIN OUTCOME MEASURES: Visual 
      acuity, Kaplan-Meier estimates of survival, local control, metastasis, and loss 
      of the eye over the duration of follow-up. RESULTS: Twenty-seven patients (13 
      men) met our inclusion criteria. Median (range) follow-up from initial treatment 
      was 100 months (14-365 months), while median time to local recurrence was 
      43 months (9-185 months). Median (range) follow-up after retreatment was 
      47 months (3-120 months). Kaplan-Meier estimate for local control at 5 years was 
      77.2% (95% confidence interval [CI], 53.29%-89.91%). All marginal recurrences 
      were successfully retreated whereas 6 of 15 patients with central recurrence 
      developed subsequent re-recurrence following salvage EPBT. Median (range) visual 
      acuity was 20/70 (20/20 to counting fingers at 1 foot) at time of recurrence and 
      declined to counting fingers (20/25 to hand motion) at the most recent follow-up 
      examination. Kaplan-Meier estimate for absence of metastatic disease at 5 years 
      was 78.5% (95% CI, 54.77%-90.70%). CONCLUSIONS: Repeat I-125 EPBT offers a viable 
      alternative to enucleation in patients with local recurrence of PUM, yielding 
      high rates of local control with predictable decline in visual acuity.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - King, Benjamin
AU  - King B
AD  - Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee 
      Health Science Center, College of Medicine, Memphis, Tennessee.
FAU - Morales-Tirado, Vanessa M
AU  - Morales-Tirado VM
AD  - Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee 
      Health Science Center, College of Medicine, Memphis, Tennessee; Department of 
      Microbiology, Immunology, and Biochemistry, University of Tennessee Health 
      Science Center, College of Medicine, Memphis, Tennessee.
FAU - Wynn, Henry G
AU  - Wynn HG
AD  - Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee 
      Health Science Center, College of Medicine, Memphis, Tennessee.
FAU - Gao, Brad T
AU  - Gao BT
AD  - Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee 
      Health Science Center, College of Medicine, Memphis, Tennessee.
FAU - Ballo, Matthew T
AU  - Ballo MT
AD  - Department of Radiation Oncology, University of Tennessee Health Science Center, 
      College of Medicine, Memphis, Tennessee.
FAU - Wilson, Matthew W
AU  - Wilson MW
AD  - Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee 
      Health Science Center, College of Medicine, Memphis, Tennessee; Department of 
      Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee. Electronic 
      address: mwilson5@uthsc.edu.
LA  - eng
PT  - Journal Article
DEP - 20161231
PL  - United States
TA  - Am J Ophthalmol
JT  - American journal of ophthalmology
JID - 0370500
RN  - 0 (Iodine Radioisotopes)
RN  - Uveal melanoma
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Brachytherapy/*methods
MH  - Dose-Response Relationship, Radiation
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Iodine Radioisotopes/therapeutic use
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Melanoma/diagnosis/mortality/*radiotherapy
MH  - Middle Aged
MH  - Neoplasm Recurrence, Local/epidemiology
MH  - Neoplasm Staging
MH  - Retrospective Studies
MH  - Sclera
MH  - Survival Rate/trends
MH  - Tennessee/epidemiology
MH  - Time Factors
MH  - Treatment Outcome
MH  - Uvea/diagnostic imaging
MH  - Uveal Neoplasms/diagnosis/mortality/*radiotherapy
MH  - Visual Acuity
EDAT- 2017/01/04 06:00
MHDA- 2017/05/10 06:00
CRDT- 2017/01/04 06:00
PHST- 2016/10/14 00:00 [received]
PHST- 2016/12/20 00:00 [revised]
PHST- 2016/12/23 00:00 [accepted]
PHST- 2017/01/04 06:00 [pubmed]
PHST- 2017/05/10 06:00 [medline]
PHST- 2017/01/04 06:00 [entrez]
AID - S0002-9394(16)30629-8 [pii]
AID - 10.1016/j.ajo.2016.12.022 [doi]
PST - ppublish
SO  - Am J Ophthalmol. 2017 Apr;176:40-45. doi: 10.1016/j.ajo.2016.12.022. Epub 2016 
      Dec 31.