Novel Eye Plaque Designs for Brachytherapy of Iris and Ciliary Body Melanoma and the First Clinical Application.
Brachytherapy
Eye plaque
Iris-ciliary body
Melanoma
Journal
Ocular oncology and pathology
ISSN: 2296-4681
Titre abrégé: Ocul Oncol Pathol
Pays: Switzerland
ID NLM: 101656139
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
10
07
2018
accepted:
17
08
2018
entrez:
4
5
2019
pubmed:
3
5
2019
medline:
3
5
2019
Statut:
ppublish
Résumé
While traditional eye plaque brachytherapy can be used for the treatment of iris melanoma, it faces challenges of poor patient tolerability due to cornea-plaque touch caused by radius of curvature mismatch and potential dosimetric inaccuracy from incomplete coverage. We present novel plaque designs and the first clinical application of the plaques for iris melanoma. Two dome-shaped plaques (EP2132 and EP1930) were designed to vault above the cornea to treat tumors of the iris and ciliary body. Image-based treatment planning of the first 2 clinical cases using the EP2132 plaque covered the tumor base plus a 2 mm margin and the involved ciliary body with at least 75 Gy to the tumor apex. The tumors decreased in size following treatment. The patients tolerated the treatment well. There was no adverse event associated with the traditional iris plaques, such as decreased vision, pain, corneal edema, glaucoma, or cataract. The novel dome-shaped plaques for the treatment of iris melanoma provide effective dose distribution, improved surgical maneuverability, and increased tolerability for the patient. This plaque model can be used to treat iris melanoma of various sizes, configurations, and locations, including the ciliary body. The need for a customized plaque platform for each patient is minimized.
Sections du résumé
BACKGROUND
BACKGROUND
While traditional eye plaque brachytherapy can be used for the treatment of iris melanoma, it faces challenges of poor patient tolerability due to cornea-plaque touch caused by radius of curvature mismatch and potential dosimetric inaccuracy from incomplete coverage. We present novel plaque designs and the first clinical application of the plaques for iris melanoma.
METHODS
METHODS
Two dome-shaped plaques (EP2132 and EP1930) were designed to vault above the cornea to treat tumors of the iris and ciliary body. Image-based treatment planning of the first 2 clinical cases using the EP2132 plaque covered the tumor base plus a 2 mm margin and the involved ciliary body with at least 75 Gy to the tumor apex.
RESULTS
RESULTS
The tumors decreased in size following treatment. The patients tolerated the treatment well. There was no adverse event associated with the traditional iris plaques, such as decreased vision, pain, corneal edema, glaucoma, or cataract.
CONCLUSION
CONCLUSIONS
The novel dome-shaped plaques for the treatment of iris melanoma provide effective dose distribution, improved surgical maneuverability, and increased tolerability for the patient. This plaque model can be used to treat iris melanoma of various sizes, configurations, and locations, including the ciliary body. The need for a customized plaque platform for each patient is minimized.
Identifiants
pubmed: 31049331
doi: 10.1159/000493269
pii: oop-0005-0220
pmc: PMC6489066
doi:
Types de publication
Journal Article
Langues
eng
Pagination
220-227Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
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