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Background <p>Proprietary bi-nuclide plaques combine the radiation properties of beta and gamma brachytherapy and can irradiate a larger target volume compared to ruthenium-plaques. While reducing the dose to structures outside the target volume, brachytherapy with bi-nuclide-plaques (BBNP) delivers a higher target dose compared to iodine-plaques. We aimed at analyzing the local tumor control and eye retention probability after BBNP.</p> Methods <p>All consecutive cases with large uveal melanoma (tumor thickness ≥ 7&#xa0;mm) treated with BBNP at our institution between 01/1999 and 12/2020 were included (n = 576, median follow-up: 30.8&#xa0;months [interquartile range, IQR: 12.9–57.4]). Univariable and multivariable Cox regression analyses were performed.</p> Results <p>Secondary enucleation (SE) was performed in 13.5% of cases (n = 78) after the median of 20.0&#xa0;months (IQR: 9.0–34.7) post-BBNP. The overall rate of local tumor recurrence (LR) in the cohort was 8.5% (n = 49) and was diagnosed at the median post-BBNP interval of 20.0&#xa0;months (IQR: 15.6–35.2). Of the patients’ baseline characteristics, higher age (&gt; 67&#xa0;years, adjusted hazard ratio [aHR] = 1.80, <i>p =</i> 0.011), tumor thickness (&gt; 8.5&#xa0;mm, aHR = 2.20, <i>p =</i> 0.002), visual acuity (&gt; 0.5 logMAR, aHR = 1.83, <i>p =</i> 0.009), and sclera dose (&gt; 1000&#xa0;Gy, aHR = 1.65, <i>p =</i> 0.034) were independently associated with the risk of SE. In turn, higher age (&gt; 67&#xa0;years, aHR = 1.93, <i>p =</i> 0.023), tumor thickness (&gt; 8.5&#xa0;mm, aHR = 2.02, <i>p =</i> 0.020), and visual acuity (&gt; 0.5 logMAR, aHR = 2.27, <i>p =</i> 0.005) were independently related to LR.</p> Conclusions <p>BBNP facilitates eye retention in 86.5% of patients with large uveal melanoma 2.5&#xa0;years after treatment. Patients’ baseline, tumor and treatment characteristics were strongly associated with the risk of SE and LR after BBNP.</p>

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Anatomical outcome after brachytherapy with bi-nuclide (Ru-106/Iodine-125) plaques in large uveal melanomas

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  • 发表日期：

    2025年7月31日

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  • Leyla Jabbarli,
  • Miltiadis Fiorentzis,
  • Maja Guberina,
  • Boerge Schmidt,
  • Philipp Rating,
  • Eva Biewald,
  • Nika Guberina,
  • Dirk Flühs,
  • Norbert Bornfeld,
  • Wolfgang Sauerwein,
  • Martin Stuschke,
  • Nikolaos E. Bechrakis

摘要

Background

Proprietary bi-nuclide plaques combine the radiation properties of beta and gamma brachytherapy and can irradiate a larger target volume compared to ruthenium-plaques. While reducing the dose to structures outside the target volume, brachytherapy with bi-nuclide-plaques (BBNP) delivers a higher target dose compared to iodine-plaques. We aimed at analyzing the local tumor control and eye retention probability after BBNP.

Methods

All consecutive cases with large uveal melanoma (tumor thickness ≥ 7 mm) treated with BBNP at our institution between 01/1999 and 12/2020 were included (n = 576, median follow-up: 30.8 months [interquartile range, IQR: 12.9–57.4]). Univariable and multivariable Cox regression analyses were performed.

Results

Secondary enucleation (SE) was performed in 13.5% of cases (n = 78) after the median of 20.0 months (IQR: 9.0–34.7) post-BBNP. The overall rate of local tumor recurrence (LR) in the cohort was 8.5% (n = 49) and was diagnosed at the median post-BBNP interval of 20.0 months (IQR: 15.6–35.2). Of the patients’ baseline characteristics, higher age (> 67 years, adjusted hazard ratio [aHR] = 1.80, p = 0.011), tumor thickness (> 8.5 mm, aHR = 2.20, p = 0.002), visual acuity (> 0.5 logMAR, aHR = 1.83, p = 0.009), and sclera dose (> 1000 Gy, aHR = 1.65, p = 0.034) were independently associated with the risk of SE. In turn, higher age (> 67 years, aHR = 1.93, p = 0.023), tumor thickness (> 8.5 mm, aHR = 2.02, p = 0.020), and visual acuity (> 0.5 logMAR, aHR = 2.27, p = 0.005) were independently related to LR.

Conclusions

BBNP facilitates eye retention in 86.5% of patients with large uveal melanoma 2.5 years after treatment. Patients’ baseline, tumor and treatment characteristics were strongly associated with the risk of SE and LR after BBNP.