1. BRACHYTHERAPY ALONE OR WITH NEOADJUVANT PHOTODYNAMIC THERAPY FOR AMELANOTIC CHOROIDAL MELANOMA
- Author
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Michela Laguardia, Antonio Villano, Monica Maria Pagliara, Luca Tagliaferri, Carmela Grazia Caputo, Andrea Scupola, and Maria Antonietta Blasi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Porphyrins ,Visual acuity ,medicine.medical_treatment ,Brachytherapy ,Visual Acuity ,Urology ,Photodynamic therapy ,amelanotic uveal melanoma ,episcleral plaque brachytherapy ,photodynamic therapy ,Ophthalmology ,Iodine Radioisotopes ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Combined Modality Therapy ,Prospective Studies ,Fluorescein Angiography ,Prospective cohort study ,Neoadjuvant therapy ,Aged ,Aged, 80 and over ,Photosensitizing Agents ,medicine.diagnostic_test ,business.industry ,Settore MED/30 - MALATTIE APPARATO VISIVO ,Choroid Neoplasms ,Verteporfin ,Melanoma, Amelanotic ,Radiotherapy Dosage ,General Medicine ,Middle Aged ,Fluorescein angiography ,Neoadjuvant Therapy ,Surgery ,Photochemotherapy ,030220 oncology & carcinogenesis ,030221 ophthalmology & optometry ,Optic nerve ,Female ,Ruthenium Radioisotopes ,medicine.symptom ,business - Abstract
PURPOSE To compare visual outcomes and local tumor control between two groups of patients with amelanotic choroidal melanoma treated with brachytherapy alone, or neoadjuvant photodynamic therapy before brachytherapy. METHODS Patients diagnosed with amelanotic choroidal melanoma were recruited for the study and divided into two groups: brachytherapy alone (Group A) and photodynamic therapy preceding brachytherapy (Group B). Patients of both groups were selected to be comparable. RESULTS Twenty-six patients with amelanotic choroidal melanoma were enrolled in the study. Within Group B, 1 month after photodynamic therapy, ultrasonography showed reduction of tumor height in 11 patients (73.4%). The mean doses of irradiation to macula and optic nerve, at baseline were 74.37 and 52.07 Gy, whereas after photodynamic therapy there was a decrease of 17.26% (P = 0.008) and 21.22% (P = 0.025), respectively. In terms of visual acuity, a mean decrease of 14 ETDRS letters and 5 ETDRS letters was observed at 24 months follow-up, in Groups A and B, respectively (P = 0.001). CONCLUSION Photodynamic therapy as neoadjuvant therapy before brachytherapy reduces tumor thickness in 73.4% of cases. As a result, a decrease of radiation toxic effects on visual function could be obtained, without compromising disease control.
- Published
- 2016
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