Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48560/rspo.25970 |
Resumo: | INTRODUCTION: Plaque brachytherapy is an established modality for the treatment of eligible choroidal melanomas. Radiation retinopathy (RR) is a known complication of brachy- therapy, responsible in part for the loss of vision after treatment. We aim to present the first report on the incidence and the predictors of radiation retinopathy after the treatment of choroidal mela- nomas in the Portuguese Ocular Oncology Reference Centre. METHODS: Retrospective case series of eligible choroidal melanoma patients submitted to plaque brachytherapy with I125 in the Ocular Oncology Unit of the Coimbra University and Hos- pital Centre (CHUC) between 2013-2021. Clinical, tumor and treatment variables were collected. Primary endpoints were defined as the cumulative incidence and the incidence rate of RR. Sec- ondary endpoints were the clinical predictors of RR as obtained through multivariable logistic regression. Candidate variables were determined through univariate logistic regression, based on clinical and an α level of 0.15. Using these variables, we built a stepwise multivariable logistic regression model, for which we considered an α level of 0.05. RESULTS: We included 150 eyes of 150 patients, mean aged 61.1±13.3 years and a median follow-up time of 33.5 months (15-52). Incidence rate of RR was 2.14/100 person-years, and the cu- mulative incidence of radiation retinopathy was 44.7% (67/150). Median time to RR development was 13 (7-18) months. Multivariable logistic regression revealed increased odds of RR with higher baseline tumor thickness (OR 1.39; 1.17-1.65; p<0.01), decreased odds of RR with pre-equator lo- cation of the tumor (OR 0.32; 0.11-0.95; p=0.04), and a trend towards decreased odds of RR with increasing age (OR 0.97; 0.95-1.00; p=0.07). CONCLUSION: The incidence of radiation retinopathy in our cohort agrees with results of published landmark trials in plaque brachytherapy. Increased baseline tumor thickness increased the odds of RR, while pre-equatorial location protected against RR and increased age showed a trend towards a protective effect. |
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Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal MelanomaIncidência e Preditores de Retinopatia da Radiação Após Braquiterapia em Placa com I125 para o Tratamento do Melanoma da CoróideArtigos OriginaisINTRODUCTION: Plaque brachytherapy is an established modality for the treatment of eligible choroidal melanomas. Radiation retinopathy (RR) is a known complication of brachy- therapy, responsible in part for the loss of vision after treatment. We aim to present the first report on the incidence and the predictors of radiation retinopathy after the treatment of choroidal mela- nomas in the Portuguese Ocular Oncology Reference Centre. METHODS: Retrospective case series of eligible choroidal melanoma patients submitted to plaque brachytherapy with I125 in the Ocular Oncology Unit of the Coimbra University and Hos- pital Centre (CHUC) between 2013-2021. Clinical, tumor and treatment variables were collected. Primary endpoints were defined as the cumulative incidence and the incidence rate of RR. Sec- ondary endpoints were the clinical predictors of RR as obtained through multivariable logistic regression. Candidate variables were determined through univariate logistic regression, based on clinical and an α level of 0.15. Using these variables, we built a stepwise multivariable logistic regression model, for which we considered an α level of 0.05. RESULTS: We included 150 eyes of 150 patients, mean aged 61.1±13.3 years and a median follow-up time of 33.5 months (15-52). Incidence rate of RR was 2.14/100 person-years, and the cu- mulative incidence of radiation retinopathy was 44.7% (67/150). Median time to RR development was 13 (7-18) months. Multivariable logistic regression revealed increased odds of RR with higher baseline tumor thickness (OR 1.39; 1.17-1.65; p<0.01), decreased odds of RR with pre-equator lo- cation of the tumor (OR 0.32; 0.11-0.95; p=0.04), and a trend towards decreased odds of RR with increasing age (OR 0.97; 0.95-1.00; p=0.07). CONCLUSION: The incidence of radiation retinopathy in our cohort agrees with results of published landmark trials in plaque brachytherapy. Increased baseline tumor thickness increased the odds of RR, while pre-equatorial location protected against RR and increased age showed a trend towards a protective effect.INTRODUÇÃO: A braquiterapia episcleral é uma opção terapêutica estabelecida no tratamento de melanomas da coroideia. Uma complicação conhecida da braquiterapia, a retinopatia da radiação (RR) é parcialmente responsável pela perda de visão após o tratamento. O nosso objetivo é apresentar o primeiro relato da incidência e respetivos fatores preditores de RR após tratamento do melanoma da coroideia no Centro de Referência em Onco-Oftalmologia. MÉTODOS: Série retrospetiva de casos de melanoma da coroideia submetidos a tratamen- to com braquiterapia episcleral com I125 no Centro de Referência de Onco-Oftalmologia do Centro Hospitalar e Universitário de Coimbra (CHUC), entre 2013-2021. Foram recolhidas variáveis demográficas, relativas ao tumor e ao protocolo de tratamento. Os desfechos primários foram definidos como a incidência cumulativa e taxa de incidência de RR. Os desfechos secundários foram definidos como os preditores de RR obtidos através de regressão logística multivariada. As variáveis selecionadas para a construção do modelo final multivariado foram selecionadas por via de regressão logística univariada, com base no seu potencial interesse clínico-patológico e/ou um valor de p<0,15. Com base nestas variáveis, foi construído um modelo multivariado stepwise, no qual foram incluídas variáveis com interesse clínico-patológico e/ou um valor de p<0,05. RESULTADOS: Foram incluídos 150 olhos de 150 doentes, com idade média de 61,1±13,3 anos e um tempo mediano de seguimento de 33,5 meses (15-52). A taxa de incidência de RR foi 2,14/100 pessoas-ano e a incidência cumulativa de RR foi de 44,7% (67/150). O tempo mediano para o desenvolvimento de RR foi de 13 (7-18) meses. O modelo multivariado revelou uma maior probabilidade de RR na presença de maior espessura inicial do tumor (OR 1,9; 1,17-1,65; p<0,01) e menor probabilidade de RR com localização tumoral anterior ao equador (OR 0,32; 0,11-0,95; p=0,04). O mesmo modelo multivariado revelou uma tendência para menor probabilidade de RR com o aumento da idade do doente (OR 0,97; 0,95-1,00; p=0,07). CONCLUSÃO: A incidência de RR na população deste estudo é concordante com os resul- tados de ensaios clínicos em braquiterapia episcleral. A maior espessura tumoral associou-se a maior probabilidade de RR, enquanto a localização anterior ao equador pareceu protetora quanto ao desenvolvimento de RR. Da mesma forma, a idade avançada do doente apresentou uma tendência, ainda que não significativa, para menor desenvolvimento de RR.Ajnet2023-03-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.48560/rspo.25970eng1646-69501646-6950Neves, EmmanuelChaves, JoãoFonseca, CristinaProença, Ruiinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-30T20:30:13Zoai:ojs.revistas.rcaap.pt:article/25970Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:48:08.899076Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma Incidência e Preditores de Retinopatia da Radiação Após Braquiterapia em Placa com I125 para o Tratamento do Melanoma da Coróide |
title |
Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma |
spellingShingle |
Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma Neves, Emmanuel Artigos Originais |
title_short |
Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma |
title_full |
Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma |
title_fullStr |
Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma |
title_full_unstemmed |
Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma |
title_sort |
Incidence and Predictors of Radiation Retinopathy after I125 Plaque Brachytherapy for the Treatment of Choroidal Melanoma |
author |
Neves, Emmanuel |
author_facet |
Neves, Emmanuel Chaves, João Fonseca, Cristina Proença, Rui |
author_role |
author |
author2 |
Chaves, João Fonseca, Cristina Proença, Rui |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Neves, Emmanuel Chaves, João Fonseca, Cristina Proença, Rui |
dc.subject.por.fl_str_mv |
Artigos Originais |
topic |
Artigos Originais |
description |
INTRODUCTION: Plaque brachytherapy is an established modality for the treatment of eligible choroidal melanomas. Radiation retinopathy (RR) is a known complication of brachy- therapy, responsible in part for the loss of vision after treatment. We aim to present the first report on the incidence and the predictors of radiation retinopathy after the treatment of choroidal mela- nomas in the Portuguese Ocular Oncology Reference Centre. METHODS: Retrospective case series of eligible choroidal melanoma patients submitted to plaque brachytherapy with I125 in the Ocular Oncology Unit of the Coimbra University and Hos- pital Centre (CHUC) between 2013-2021. Clinical, tumor and treatment variables were collected. Primary endpoints were defined as the cumulative incidence and the incidence rate of RR. Sec- ondary endpoints were the clinical predictors of RR as obtained through multivariable logistic regression. Candidate variables were determined through univariate logistic regression, based on clinical and an α level of 0.15. Using these variables, we built a stepwise multivariable logistic regression model, for which we considered an α level of 0.05. RESULTS: We included 150 eyes of 150 patients, mean aged 61.1±13.3 years and a median follow-up time of 33.5 months (15-52). Incidence rate of RR was 2.14/100 person-years, and the cu- mulative incidence of radiation retinopathy was 44.7% (67/150). Median time to RR development was 13 (7-18) months. Multivariable logistic regression revealed increased odds of RR with higher baseline tumor thickness (OR 1.39; 1.17-1.65; p<0.01), decreased odds of RR with pre-equator lo- cation of the tumor (OR 0.32; 0.11-0.95; p=0.04), and a trend towards decreased odds of RR with increasing age (OR 0.97; 0.95-1.00; p=0.07). CONCLUSION: The incidence of radiation retinopathy in our cohort agrees with results of published landmark trials in plaque brachytherapy. Increased baseline tumor thickness increased the odds of RR, while pre-equatorial location protected against RR and increased age showed a trend towards a protective effect. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-03-28 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48560/rspo.25970 |
url |
https://doi.org/10.48560/rspo.25970 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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1646-6950 1646-6950 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Ajnet |
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Ajnet |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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