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Brachytherapy in the prevention of recurrence of conjunctival melanoma

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

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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.

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References

  1. McLaughlin CC, Wu X‑C, Jemal A et al (2005) Incidence of noncutaneous melanomas in the U.S. Cancer 103:1000–1007

    Article  PubMed  Google Scholar 

  2. Isager P, Østerlind A, Engholm G et al (2005) Uveal and conjunctival malignant melanoma in Denmark, 1943–97: incidence and validation study. Ophthalmic Epidemiol 1:223–232

    Article  Google Scholar 

  3. 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 11:153–160

    Article  PubMed  PubMed Central  Google Scholar 

  4. Saornil MA, Becerra E, Méndez MC et al (2009) Tumores de la conjuntiva. Arch La Soc Española Oftalmol 84:7–22

    CAS  Google Scholar 

  5. Shields CL, Markowitz JS, Belinsky I et al (2011) Conjunctival melanoma: outcomes based on tumor origin in 382 consecutive cases. Ophthalmology 118:389–395

    Article  PubMed  Google Scholar 

  6. Cohen VML, O’Day RF (2019) Management issues in conjunctival tumours: conjunctival melanoma and primary acquired melanosis. Ophthalmol Ther 8:501–510

    Article  PubMed  PubMed Central  Google Scholar 

  7. Shields CL (2000) Conjunctival melanoma: risk factors for recurrence, exenteration, metastasis, and death in 150 consecutive patients. Trans Am Ophthalmol Soc 98:471–492

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Kao A, Afshar A, Bloomer M et al (2016) Management of primary acquired melanosis, nevus, and conjunctival melanoma. Cancer Control 23:117–125

    Article  PubMed  Google Scholar 

  9. 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 118:1497–1507

    Article  CAS  PubMed  Google Scholar 

  10. Damato B, Coupland SE (2009) Management of conjunctival melanoma. Expert Rev Anticancer Ther 9:1227–1239

    Article  PubMed  Google Scholar 

  11. 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 94:218–224

    Article  CAS  Google Scholar 

  12. Brouwer NJ, Marinkovic M, van Duinen SG et al (2018) Treatment of conjunctival melanoma in a Dutch referral centre. Br J Ophthalmol 102:1277–1282

    Article  PubMed  Google Scholar 

  13. 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 9:287–295

    Article  PubMed  PubMed Central  Google Scholar 

  14. Simpson ER, Gallie B, Laperrierre N (2014) The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma. Brachytherapy 13:1–14

    Article  Google Scholar 

  15. 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

    Google Scholar 

  16. 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 56:544–555

    Article  PubMed  Google Scholar 

  17. Simpson ER, Gallie B, Laperrierre N (2014) The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma. Brachytherapy 131:1–14

    Article  Google Scholar 

  18. Miguel D, de Frutos JM, López-Lara F et al (2019) Treatment planning considerations for 125I eye plaque brachytherapy. J Contemp Brachytherapy 11:280–284

    Article  PubMed  PubMed Central  Google Scholar 

  19. ISO (2009) International Organisation for Standardization. Clinical Dosimetry—Beta Radiation Sources for Brachytherapy. International Organisation for Standardization), Geneva

    Google Scholar 

  20. 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 47:92–124

    Article  Google Scholar 

  21. Astrahan MA, Luxton G, Jozsef G et al (1990) An interactive treatment planning system for ophthalmic plaque radiotherapy. Int J Radiat Oncol Biol Phys 18:679–687

    Article  CAS  PubMed  Google Scholar 

  22. 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 22:209–234

    Article  CAS  PubMed  Google Scholar 

  23. 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 31:633–674

    Article  PubMed  Google Scholar 

  24. Treacher Collins E (1918) Case of epibulbar sarcoma cured by its removal and the application of radium. Trans Ophthal Soc Uk 38:125–127

    Google Scholar 

  25. Lommatzsch PK, Lommatzsch RE, Kirsch I et al (1990) Therapeutic outcome of patients suffering from malignant melanomas of the conjunctiva. Br J Ophthalmol 74:615–619

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Walsh-Conway N, Conway RM (2009) Plaque brachytherapy for the management of ocular surface malignancies with corneoscleral invasion. Clin Exp Ophthalmol 37:577–583

    Article  PubMed  Google Scholar 

  27. Karim R, Conway RM (2011) Conservative resection and adjuvant plaque brachytherapy for early stage conjuctival melanoma. Clin Experiment Ophthalmol 39:293–298

    Article  PubMed  Google Scholar 

  28. Shields CL, Shields JA (2004) Tumors of the conjunctiva and cornea. Surv Ophthalmol 49:3–24

    Article  PubMed  Google Scholar 

  29. 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

    Google Scholar 

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Authors and Affiliations

  1. Ocular Oncology Unit, Ophthalmology Department, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain

    Gabriela Estefanía Pacheco-Callirgos, Ciro García-Alvarez, Luis Garcia-Onrubia & Maria Antonia Saornil-Alvarez

  2. Oncology Radiotherapy Department, Hospital Clínico Universitario de Valladolid, 47003, Valladolid, Spain

    David Miguel-Pérez, Pilar Alonso-Martinez, Patricia Diezhandino & Jesus Maria de Frutos Barajas

Authors
  1. Gabriela Estefanía Pacheco-Callirgos
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  2. Ciro García-Alvarez
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  3. Luis Garcia-Onrubia
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  4. David Miguel-Pérez
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  5. Pilar Alonso-Martinez
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  6. Patricia Diezhandino
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  7. Jesus Maria de Frutos Barajas
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  8. Maria Antonia Saornil-Alvarez
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Corresponding author

Correspondence to Gabriela Estefanía Pacheco-Callirgos.

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Conflict of interest

G.E. Pacheco-Callirgos, C. García-Alvarez, L. Garcia-Onrubia, D. Miguel-Pérez, P. Alonso-Martinez, P. Diezhandino, J.M. de Frutos Barajas, and M.A. Saornil-Alvarez declare that they have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript.

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Pacheco-Callirgos, G.E., García-Alvarez, C., Garcia-Onrubia, L. et al. Brachytherapy in the prevention of recurrence of conjunctival melanoma. Strahlenther Onkol 199, 1025–1030 (2023). https://doi.org/10.1007/s00066-023-02094-6

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  • DOI: https://doi.org/10.1007/s00066-023-02094-6

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