Andrey A. Yarovoy, Denis P. Volodin, Vera A. Yarovaya
{"title":"钌-106和锶-90眼斑治疗视网膜母细胞瘤的回顾性研究：16年临床经验。","authors":"Andrey A. Yarovoy, Denis P. Volodin, Vera A. Yarovaya","doi":"10.1016/j.brachy.2024.11.008","DOIUrl":null,"url":null,"abstract":"<div><h3>PURPOSE</h3><div>To retrospectively evaluate the efficacy of plaque brachytherapy for the treatment of retinoblastoma.</div></div><div><h3>METHODS</h3><div>We retrospectively reviewed the clinical records of 163 patients (186 eyes, 333 tumors) treated with brachytherapy (<sup>106</sup>Ru or <sup>90</sup>Sr plaques) for intraocular retinoblastoma between November 2007 and August 2023.</div></div><div><h3>RESULTS</h3><div>Complete tumor control was achieved in 273 tumors (82%). Incomplete tumor control was observed in 44 tumors (13%). Thirteen tumors presented with tumor progression. Three tumors relapsed after brachytherapy. On multivariate statistical analysis apex dose ≤ 85 Gy (for <sup>106</sup>Ru) (<em>p</em> = 0.03), dark fundus pigmentation (<em>p =</em> 0.005) and intraarterial chemotherapy-brachytherapy period < 2 months (<em>p</em> = 0.001) demonstrated significant effect on brachytherapy insufficiency.</div><div>Radiation-induced complications occurred in 62 eyes (33%). The most frequent complications were nonproliferative retinopathy (n = 39, 21%), optic neuropathy (n = 29, 16%) and vitreous hemorrhage (n = 29, 16%). Multivariate statistical analysis showed central localization (<em>p</em> = 0.005), tumor thickness > 2.7 mm (p = 0.04) and larger plaque diameter (>14 mm) (<em>p =</em> 0.035) to be the most significant variables for brachytherapy-associated complications.</div><div>Eye retention was achieved in 91% of the treated eyes (n = 169). 17 eyes (9%) were enucleated. The reasons for enucleation were tumor recurrence or uncontrolled tumor growth (n = 7), anterior chamber involvement (n = 3), recurrent active vitreous seeding (n = 1), inability of adequate tumor monitoring due to opaque media (dense total vitreous hemorrhage or total retinal detachment) (n = 3), subatrophy of the eye with functional blindness (n = 3).</div></div><div><h3>CONCLUSION</h3><div>Overall, Beta-ray brachytherapy proved to be a highly effective method of retinoblastoma treatment with excellent local tumor control, eye preservation rate and acceptable incidence of curable radiation-induced complications.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 265-272"},"PeriodicalIF":1.7000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A retrospective study on ruthenium-106 and strontium-90 eye-plaques treatment for retinoblastoma: 16-years clinical experience\",\"authors\":\"Andrey A. Yarovoy, Denis P. Volodin, Vera A. Yarovaya\",\"doi\":\"10.1016/j.brachy.2024.11.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>PURPOSE</h3><div>To retrospectively evaluate the efficacy of plaque brachytherapy for the treatment of retinoblastoma.</div></div><div><h3>METHODS</h3><div>We retrospectively reviewed the clinical records of 163 patients (186 eyes, 333 tumors) treated with brachytherapy (<sup>106</sup>Ru or <sup>90</sup>Sr plaques) for intraocular retinoblastoma between November 2007 and August 2023.</div></div><div><h3>RESULTS</h3><div>Complete tumor control was achieved in 273 tumors (82%). Incomplete tumor control was observed in 44 tumors (13%). Thirteen tumors presented with tumor progression. Three tumors relapsed after brachytherapy. On multivariate statistical analysis apex dose ≤ 85 Gy (for <sup>106</sup>Ru) (<em>p</em> = 0.03), dark fundus pigmentation (<em>p =</em> 0.005) and intraarterial chemotherapy-brachytherapy period < 2 months (<em>p</em> = 0.001) demonstrated significant effect on brachytherapy insufficiency.</div><div>Radiation-induced complications occurred in 62 eyes (33%). The most frequent complications were nonproliferative retinopathy (n = 39, 21%), optic neuropathy (n = 29, 16%) and vitreous hemorrhage (n = 29, 16%). Multivariate statistical analysis showed central localization (<em>p</em> = 0.005), tumor thickness > 2.7 mm (p = 0.04) and larger plaque diameter (>14 mm) (<em>p =</em> 0.035) to be the most significant variables for brachytherapy-associated complications.</div><div>Eye retention was achieved in 91% of the treated eyes (n = 169). 17 eyes (9%) were enucleated. The reasons for enucleation were tumor recurrence or uncontrolled tumor growth (n = 7), anterior chamber involvement (n = 3), recurrent active vitreous seeding (n = 1), inability of adequate tumor monitoring due to opaque media (dense total vitreous hemorrhage or total retinal detachment) (n = 3), subatrophy of the eye with functional blindness (n = 3).</div></div><div><h3>CONCLUSION</h3><div>Overall, Beta-ray brachytherapy proved to be a highly effective method of retinoblastoma treatment with excellent local tumor control, eye preservation rate and acceptable incidence of curable radiation-induced complications.</div></div>\",\"PeriodicalId\":55334,\"journal\":{\"name\":\"Brachytherapy\",\"volume\":\"24 2\",\"pages\":\"Pages 265-272\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Brachytherapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1538472124004586\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brachytherapy","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1538472124004586","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
A retrospective study on ruthenium-106 and strontium-90 eye-plaques treatment for retinoblastoma: 16-years clinical experience
PURPOSE
To retrospectively evaluate the efficacy of plaque brachytherapy for the treatment of retinoblastoma.
METHODS
We retrospectively reviewed the clinical records of 163 patients (186 eyes, 333 tumors) treated with brachytherapy (106Ru or 90Sr plaques) for intraocular retinoblastoma between November 2007 and August 2023.
RESULTS
Complete tumor control was achieved in 273 tumors (82%). Incomplete tumor control was observed in 44 tumors (13%). Thirteen tumors presented with tumor progression. Three tumors relapsed after brachytherapy. On multivariate statistical analysis apex dose ≤ 85 Gy (for 106Ru) (p = 0.03), dark fundus pigmentation (p = 0.005) and intraarterial chemotherapy-brachytherapy period < 2 months (p = 0.001) demonstrated significant effect on brachytherapy insufficiency.
Radiation-induced complications occurred in 62 eyes (33%). The most frequent complications were nonproliferative retinopathy (n = 39, 21%), optic neuropathy (n = 29, 16%) and vitreous hemorrhage (n = 29, 16%). Multivariate statistical analysis showed central localization (p = 0.005), tumor thickness > 2.7 mm (p = 0.04) and larger plaque diameter (>14 mm) (p = 0.035) to be the most significant variables for brachytherapy-associated complications.
Eye retention was achieved in 91% of the treated eyes (n = 169). 17 eyes (9%) were enucleated. The reasons for enucleation were tumor recurrence or uncontrolled tumor growth (n = 7), anterior chamber involvement (n = 3), recurrent active vitreous seeding (n = 1), inability of adequate tumor monitoring due to opaque media (dense total vitreous hemorrhage or total retinal detachment) (n = 3), subatrophy of the eye with functional blindness (n = 3).
CONCLUSION
Overall, Beta-ray brachytherapy proved to be a highly effective method of retinoblastoma treatment with excellent local tumor control, eye preservation rate and acceptable incidence of curable radiation-induced complications.
期刊介绍：
Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.
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