RADIATION COMPLICATIONS AFTER BRACHYTHERAPY OF UVEAL MELANOMA, THEIR RELATIONS WITH CLINICAL - ECHOGRAPHIC, HEMODYNAMIC CHARACTERISTICS AND DEGREE OF TUMOR RESORPTION
Ratobylsky G.V., Nikitin M.M.
| Purpose. To determine the probability of development of some radiation complications in pa-tients with uveal melanoma (UM) after brachytherapy (BT), their relationship with different clinical and echographic characteristics of the tumor and the efficacy of local treatment. Materials and methods. 192 patients with UM - 121 (63.0%) women and 71 (37.0%) men aged 17 to 83 years were examined and treated. UM thickness was on average 5.4 ± 1.9 mm (1.4-9.5) mm, and the base diameter was 12.9 ± 2.8 mm (6.0-20.0) mm. All patients un-derwent BT with the use of 106Ru / 106Rh radioactive ophthalmic plaques. The follow-up after BT ranged from 12 to 120 months (median 54.5 months). The statistical analysis was carried out in the packages of Microsoft Windows® 7, IBM SPSS Statistics 23.0: Results. The cumulative probability of vitreos hemorrhage development after BT in 12, 36, 60 months was 15.7%, 18.4%, 19.1, respectively; radiation neuropathy - 57%, 83%, 85%, respectively; secondary glaucoma in 6 months of 2.1%, after 12 months - 7.3%; radia-tion sclerosis necrosis in 12, 36, 60 months - 2.1%, 4.1%, 4.2%, respectively. Most radiation complications were associated with large tumor sizes and, accordingly, high total surface doses of ionizing radiation. Secondary factors that affected the risk of complications were the localization of the tumor, its echographic forms. At the same time, the role of the tumor structure, its vascularization, hemodynamic characteristics of the blood flow in its own ves-sels of the tumor were minimal, even with hemodynamically caused complications. It was revealed that the nature and severity of radiation complications correlated with the course of the tumor process and the degree of UM regression after BT. Conclusion. Understanding the pathogenesis of radiation complications develop-ment, their association with the effectiveness of local tumor destruction, as well as predict-ing the probability of their development depending on the clinical features of the tumor will allow timely planning of therapeutic and preventive measures aimed to tumor resorption and preservation of the patient's eye. Compliance with strict indications for UM brachy-therapy using 106 RU / 106Rh OA will reduce the frequency and severity of radiation com-plications development. |
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Keywords: uveal melanoma, brachytherapy, radiation complications, vitreos hemorrage, radiation optic neuropathy, secondary glaucoma, scleral necrosis.
Corresponding author: Amiryan A.G.e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Neroev V.V., Saakyan S.V., Amiryan A.G., Valskiy V.V. Radiation complications after brachy-therapy of uveal melanoma, their relations with clinical - echographic, hemodynamic charac-teristics and degree of tumor resorption. REJR 2018; 8 (2):8-23. DOI:10.21569/2222-7415-2018-8-2-8-23.
Received: 05.02.2018 Accepted: 02.03.2018