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ORIGINAL ARTICLE
Year : 2022  |  Volume : 4  |  Issue : 1  |  Page : 22

Episcleral brachytherapy in Portugal for the treatment of uveal melanoma


1 Department of Ophthalmology, Hospital and University Center of Coimbra, Coimbra, Portugal
2 Department of Ophthalmology; Department of Radiation Oncology, Hospital and University Center of Coimbra, Coimbra, Portugal
3 Department of Radiation Oncology, Hospital and University Center of Coimbra, Coimbra, Portugal
4 Faculty of Medicine, University of Coimbra, Portugal

Correspondence Address:
João Chaves
Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075, Coimbra
Portugal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/pajo.pajo_135_21

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Purpose: To evaluate the outcomes of our institution, the National Ocular Oncology Reference Center (Centro Hospitalar e Universitário de Coimbra) on Episcleral Brachytherapy (EBT) for the treatment of uveal melanoma (UM), since its beginning in November 2013, regarding local control, survival rates, metastatic rates, and side effects and to compare them with the international literature. Materials and Methods: Prospective study of patients referred to the Ocular Oncology Reference Center and treated with EBT between November 2013 and August 2020. Data were collected regarding local control, survival, distant metastasis, and treatment side effects. Data analysis evaluated treatment outcomes and radiation side effects. Results: A total of 150 patients underwent EBT but only 143 were considered for analysis. In 95.5% of cases local control was achieved and only 4.5% underwent secondary enucleation due to treatment failure and disease progression. Tumor initial maximum diameter was a predictor of time to melanoma-related death (Hazard ratio [HR] = 1.24 [95% confidence interval [CI] - 1.03–1.50] P = 0.018) and time to metastasis (HR = 1.43 [95% CI - 1.2–1.71] P ≤ 0.001). Among the 143 patients, the most common radiation side effect was cataract (58.33%) followed by the development of any form of radiation retinopathy (42,36%). One patient (0.7%) underwent secondary enucleation due to uncontrolled neovascular glaucoma. Conclusions: Our results demonstrate excellent clinical outcomes of local control with EBT, with satisfactory overall survival and metastasis-free survival rates, comparable to international literature. Considering the high rates of local control and globe preservation, this research validates de use of EBT as a mainstay treatment in UM.


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