Binder Christina, Mruthyunjaya Prithvi, Schefler Amy C, Seider Michael I, Crilly Richard, Hung Arthur, Meltsner Sheridan, Mowery Yvonne, Kirsch David G, Teh Bin S, Jennelle Richard L S, Studenski Matthew T, Liu Wu, Lee Choonik, Hayman James A, Kastner Brian, Hadsell Michael, Skalet Alison H
Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon, USA.
Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, USA.
Ocul Oncol Pathol. 2020 May;6(3):210-218. doi: 10.1159/000504312. Epub 2019 Dec 11.
Treatment planning for I-125 plaque therapy for uveal melanoma has advanced significantly since the Collaborative Ocular Melanoma Study trial, with more widely available image-guided planning and improved dosimetry.
We evaluated real-world practice patterns for I-125 plaque brachytherapy in the United States by studying practice patterns at centers that comprise the Ocular Oncology Study Consortium (OOSC).
The OOSC database and responses to a treatment practice survey were evaluated. The database contains treatment information from 9 institutions. Patients included in the database were treated between 2010 and 2014. The survey was conducted in 2018 and current treatment planning methods and prescriptions were queried.
Examination of the OOSC database revealed that average doses to critical structures were highly consistent, with the exception of one institution. Survey responses indicated that most centers followed published guidelines regarding dose and prescription point. Dose rate ranged from 51 to 118 cGy/h. As of 2018, most institutions use pre-loaded plaques and fundus photographs and/or computed tomography or magnetic resonance imaging in planning.
While there were differences in dosimetric practices, overall agreement in plaque brachytherapy practices was high among OOSC institutions. Clinical margins and planning systems were similar among institutions, while prescription dose, dose rates, and dosimetry varied.
自协作性眼黑色素瘤研究试验以来，碘-125敷贴器治疗葡萄膜黑色素瘤的治疗计划有了显著进展，图像引导计划的可用性更高，剂量测定也有所改进。
我们通过研究眼肿瘤研究联盟（OOSC）各中心的实践模式，评估了美国碘-125敷贴器近距离放射治疗的实际应用模式。
对OOSC数据库及治疗实践调查问卷的回复进行了评估。该数据库包含9家机构的治疗信息。数据库中的患者于2010年至2014年接受治疗。调查于2018年进行，询问了当前的治疗计划方法和处方。
对OOSC数据库的审查显示，除一家机构外，关键结构的平均剂量高度一致。调查回复表明，大多数中心遵循已发表的关于剂量和处方点的指南。剂量率范围为51至118 cGy/h。截至2018年，大多数机构在计划中使用预装敷贴器以及眼底照片和/或计算机断层扫描或磁共振成像。
虽然在剂量测定实践方面存在差异，但OOSC机构之间在敷贴器近距离放射治疗实践方面的总体一致性较高。各机构之间的临床边界和计划系统相似，而处方剂量、剂量率和剂量测定有所不同。
