Short-term efficacy of eye-saving treatment for medium and large T1-T4 choroidal melanomas in Ukrainian population as assessed by local tumor control
DOI:
https://doi.org/10.31288/oftalmolzh202555357Abstract
Purpose. To assess the efficacy of eye-saving treatment (involving transpupillary thermotherapy (TTT) combined with strontium-90 (Sr90)/ yttrium-90 (Yt90) brachytherapy (BT)) for medium and large CM in terms of local tumor control rate at 12 months after the initiation of treatment.
Material and Methods: This retrospective cohort study included 283 patients with CM who were treated at SI “The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine” from 2007 to 2024. The study sample consisted of 125 men (44.2%) and 158 women (55.8%), with a mean age (standard deviation) of 54.2 (12.4) years. Short-term success was defined as evidence of complete tumor regression, partial tumor regression or stabilization of the tumor process at 12 months after the initiation of treatment. Short-term failure was defined as evidence of continued tumor growth, tumor recurrence (a tumor growing from the scar) or extrabulbar spread at 12 months after the initiation of treatment.
Results: Short-term treatment success was achieved in 274 patients (96.8%). Particularly, complete tumor regression was achieved in 86/274 patients (31.4%) or 86/283 patients (30.4%), partial tumor regression, in 165/274 (60.3%) or 165/283 (58.3%), and regression with stabilization of tumor size, in 23/274 (8.4%) or 23/283 (8.1%). Local treatment failure in the form of continued tumor growth was seen in 9/283 patients (3.2%) and led to enucleation.
Conclusion: More effective outcome of the eye-saving treatment (involving TTT combined with Sr90/ Yt90 BT) for CM may be expected in patients with T1 stage (tumor thickness of 3.1-6.0 mm and base diameter of 3.1-9.0 mm), T2 stage (3.1-9.0 mm; 3.1-15.0 mm), and T3 stage with category 4 tumor size (tumor thickness of 3.1-6.0 mm and base diameter of 15.1-18.0 mm) and category 5 tumor size (6.1-9.0 mm; 12.1-18.0 mm).
References
Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998 Oct 15;83(8):1664-78. https://doi.org/10.1002/(SICI)1097-0142(19981015)83:8<1664::AID-CNCR23>3.0.CO;2-G
Singh AD, Shields CL, Shields JA. Prognostic factors in uveal melanoma. Melanoma Res. 2001 Jun;11(3):255-63.https://doi.org/10.1097/00008390-200106000-00007
Ewens KG, Kanetsky PA, Richards-Yutz J, Al-Dahmash S, De Luca MC, Bianciotto CG, Shields CL, Ganguly A. Genomic profile of 320 uveal melanoma cases: chromosome 8p-loss and metastatic outcome. Invest Ophthalmol Vis Sci. 2013 Aug 23;54(8):5721-9. https://doi.org/10.1167/iovs.13-12195
Damato B, Dopierala JA, Coupland SE. Genotypic profiling of 452 choroidal melanomas with multiplex ligation-dependent probe amplification. ClinCancerRes. 2010 Dec 15;16(24):6083-92. https://doi.org/10.1158/1078-0432.CCR-10-2076
Damato B. Progress in the management of patients with uveal melanoma. The 2012 Ashton Lecture. Eye (Lond). 2012 Sep;26(9):1157-72.https://doi.org/10.1038/eye.2012.126
Shields CL, Say EAT, Hasanreisoglu M, Saktanasate J, Lawson BM, Landy JE, Badami AU, Sivalingam MD, Mashayekhi A, Shields JA, Ganguly A. Cytogenetic Abnormalities in Uveal Melanoma Based on Tumor Features and Size in 1059 Patients: The 2016 W. Richard Green Lecture. Ophthalmology. 2017 May;124(5):609-618. https://doi.org/10.1016/j.ophtha.2016.12.026
Bartlema YM, Oosterhuis JA, Journée-De Korver JG, Tjho-Heslinga RE, Keunen JE. Combined plaque radiotherapy and transpupillary thermotherapy in choroidal melanoma: 5 years' experience. Br J Ophthalmol. 2003 Nov;87(11):1370-3.https://doi.org/10.1136/bjo.87.11.1370
Blasi MA, Laguardia M, Tagliaferri L, Scupola A, Villano A, Caputo CG, Pagliara MM. Brachytherapy alone or with neoadjuvant photodynamic therapy for amelanotic choroidal melanoma: Functional Outcomes and Local Tumor Control. Retina. 2016 Nov;36(11):2205-2212. https://doi.org/10.1097/IAE.0000000000001048
Damato B, Patel I, Campbell IR, Mayles HM, Errington RD. Local tumor control after 106Ru brachytherapy of choroidal melanoma. Int J RadiatOncolBiol Phys. 2005 Oct 1;63(2):385-91. https://doi.org/10.1016/j.ijrobp.2005.02.017
Damato B, Patel I, Campbell IR, Mayles HM, Errington RD. Visual acuity after Ruthenium(106) brachytherapy of choroidal melanomas. Int J RadiatOncolBiol Phys. 2005 Oct 1;63(2):392-400. https://doi.org/10.1016/j.ijrobp.2005.02.059
Damato B. Treatment of primary intraocular melanoma. Expert Rev Anticancer Ther. 2006 Apr;6(4):493-506. https://doi.org/10.1586/14737140.6.4.493
Forte R, Cennamo G, Staibano S, De Rosa G. Echographic examination with new generation contrast agent of choroidal malignant melanomas. Acta Ophthalmol Scand. 2005 Jun;83(3):347-54.https://doi.org/10.1111/j.1600-0420.2005.00428.x
Shields CL, Shields JA, Cater J, Gündüz K, Miyamoto C, Micaily B, Brady LW. Plaque radiotherapy for uveal melanoma: long-term visual outcome in 1106 consecutive patients. ArchOphthalmol. 2000 Sep;118(9):1219-28. https://doi.org/10.1001/archopht.118.9.1219
Shields CL, Cater J, Shields JA, Chao A, Krema H, Materin M, Brady LW. Combined plaque radiotherapy and transpupillary thermotherapy for choroidal melanoma: tumor control and treatment complications in 270 consecutive patients. Arch Ophthalmol. 2002 Jul;120(7):933-40. https://doi.org/10.1001/archopht.120.7.933
Shields CL, Kaliki S, Furuta M, Mashayekhi A, Shields JA. Clinical spectrum and prognosis of uveal melanoma based on age at presentation in 8,033 cases. Retina. 2012 Jul;32(7):1363-72. https://doi.org/10.1097/IAE.0b013e31824d09a8
Singh AD, Turell ME, Topham AK. Uveal melanoma: trends in incidence, treatment, and survival. Ophthalmology. 2011 Sep;118(9):1881-5. https://doi.org/10.1016/j.ophtha.2011.01.040
Spagnolo F, Caltabiano G, Queirolo P. Uveal melanoma. Cancer Treat Rev. 2012 Aug;38(5):549-53. https://doi.org/10.1016/j.ctrv.2012.01.002
Wang Z, Nabhan M, Schild SE, Stafford SL, Petersen IA, Foote RL, Murad MH. Charged particle radiation therapy for uveal melanoma: a systematic review and meta-analysis. Int J RadiatOncolBiol Phys. 2013 May 1;86(1):18-26. https://doi.org/10.1016/j.ijrobp.2012.08.026
Leonard KL, Gagne NL, Mignano JE, Duker JS, Bannon EA, Rivard MJ. A 17-year retrospective study of institutional results for eye plaque brachytherapy of uveal melanoma using (125)I, (103)Pd, and (131)Cs and historical perspective. Brachytherapy. 2011 Jul-Aug;10(4):331-9. https://doi.org/10.1016/j.brachy.2011.01.006
Foti PV, Longo A, Reibaldi M, Russo A, Privitera G, Spatola C, Raffaele L, Salamone V, Farina R, Palmucci S, Musumeci A, Caltabiano R, Ragusa M, Mariotti C, Avitabile T, Milone P, Ettorre GC. Uveal melanoma: quantitative evaluation of diffusion-weighted MR imaging in the response assessment after proton-beam therapy, long-term follow-up. Radiol Med. 2017 Feb;122(2):131-139.https://doi.org/10.1007/s11547-016-0697-3
Information Bulletin No. 22 based on Pat. of Ukraine №102,890 issued 25.11.2015. Method for treatment of T1 choroidal melanoma. Authors: Pasyechnikova NV, Naumenko VO, Poliakova SI, Tsukanova IV. Patent Holder: State Institution "Filatov Institute of Eye Diseases and Tissue Therapy", NAMS of Ukraine.
Copyright Registration Certificate for a Work No. 135,100 issued on April 15, 2025. Method for treatment of T2-T3 choroidal melanoma with transpupillary therapy combined with Sr90/Yt90 brachytherapy. Authors: Pasyechnikova NV, Maletskiy AP, Poliakova SI, Chabotariov IeP, Tsukanova IV, Drumi DA.
Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th Edition of the AJCC Cancer Staging Manual and the Future of TNM. Ann Surg Oncol. 2010 Jun;17(6):1471-4. https://doi.org/10.1245/s10434-010-0985-4
Buhl A, Zofel P. [SPSS Version 10-Introduction to modern data analysis]. Addison-Wesley: München, Germany; 2000. German.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Drumi D. A., Poliakova S. I.
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) that allows users to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author as long as they cite the source.
COPYRIGHT NOTICE
Authors who publish in this journal agree to the following terms:
- Authors hold copyright immediately after publication of their works and retain publishing rights without any restrictions.
- The copyright commencement date complies the publication date of the issue, where the article is included in.
DEPOSIT POLICY
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) during the editorial process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work with an acknowledgement of its initial publication in this journal.
- Post-print (post-refereeing manuscript version) and publisher's PDF-version self-archiving is allowed.
- Archiving the pre-print (pre-refereeing manuscript version) not allowed.
