Clinico-ecographic factors of prediction of uveal melanoma brachytherapy efficiency

Neroev V.V., Saakyan S.V., Amiryan A.G., Valskiy V.V.

Purpose. To identify the clinical, structural and hemodynamic factors predicting the effectiveness of brachytherapy of uveal melanoma (UM). Materials and methods. A total of 192 patients with UM - 121 (63.0%) women and 71 (37.0%) men aged 17 to 83 years were examined and treated. Tumor thickness was an average was 5.4 ± 1.9 mm (1.4-9.5) mm, and the basal diameter - 12.9 ± 2.8 mm (6.0-20.0) mm. The patients underwent complex clinical and instrumental examination. High-resolution ultrasound scanning was performed on a multifunctional system Voluson® 730Pro (GE Healthcare, Austria) (12-16MHz). All patients underwent organ-preserving treatment-brachytherapy (BT). The calculation of the BT was carried out according to an individual scheme taking into account the size, localization and physical characteristics of the OA. The analysis of the results of the efficacy of BT was carried out not earlier than 18 months after BT (at the time of the abatement of the radiation reaction). The timing of follow-up after BT ranged from 12 to 210 months (median 54.3 months). The statistical analysis was carried out in the packages of Microsoft Windows® 7, IBM SPSS Statistics 23.0: Results. Complete resorption was achieved in 86 (44.8%) patients, partial resorption in 86 (44.8%) patients, stabilization of the process - in 6 (3.1%) and in 14 (7.3%) patients - continued growth after BT. It was shown that in patients with complete resorption the aver-age of prominence were lower in comparison with partial resorption, stabilization and con-tinued growth (p˂0.05), the value of the diameter of the tumor base in all groups did not differ (p˃0.05). It was found that in the group of patients with complete resorption, the densi-tometric characteristics in the apex of the tumor (A3), as well as the average for the three parameters calculated in different parts of the UM (Ame), were lower than in patients with partial resorption (p˂0,05). The predominance of domed and irregular forms of UM in patients with complete resorption was noted, and mushroom-shaped - with incomplete resorption (p˂0.05). The variants of angioarchitectonics most often associated with complete tumor resorption were revealed: preferential distribution of color codes (CC) of flows in the region of the "edges" of the tumor and uniform distribution of the CC in the projection of the UM (p˂0.05). Conclusion. The obtained data expand the notion of tumor resorption after BT, allows to predict the effectiveness of treatment, to plan a personalized approach and to determine the further tactics of managing a patient with UM.
Moscow Helmholtz Research Institute of Eye Diseases. Moscow, Russia.







Keywords:uveal melanoma, brachytherapy, treatment effectiveness, echography, vascularization, prognosis.


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: For citation: Neroev V.V., Saakyan S.V., Amiryan A.G., Valskiy V.V. Clinico - ecographic factors of prediction of uveal melanoma brachytherapy efficiency. REJR 2018; 8 (1):40-51. DOI:10.21569/2222-7415-2018-8-1-40-51.

Received: 04.03.2018 Accepted: 23.03.2018