Finger Paul T, Stewart Robert, Rivard Mark J, Beers Raymond J, Kamen Jacob, Lama Shyam, Chin Kimberly J, Mohney Kyle, Welles Toby S, Sauerwein Wolfgang A G, Rosenzweig Kenneth
The Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, The New York Eye Cancer Center, New York, NY; The Departments of Ophthalmology, Radiation Oncology, and Radiation Safety, New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, NY; Scientific Advisory Board and Employees of Liberty Vision Corporation, Portsmouth, NH.
The Departments of Ophthalmology, Radiation Oncology, and Radiation Safety, New York Eye and Ear Infirmary of Mount Sinai and Icahn School of Medicine at Mount Sinai, New York, NY.
Brachytherapy. 2023 May-Jun;22(3):416-427. doi: 10.1016/j.brachy.2023.02.004. Epub 2023 Mar 21.
Herein, we study if high-dose-rate (HDR) yttrium-90 (Y) brachytherapy could be utilized by medical physicists, radiation oncologists, and ophthalmic surgeons.
Yttrium-90 (Y) beta-emitting brachytherapy sources received United States Food and Drug Administration clearance for episcleral treatment of ocular tumors and benign growths. Dose calibration traceable to the National Institute of Standards and Technology as well as treatment planning and target delineation methods were established. Single-use systems included a Y-disc affixed within specialized, multifunction, handheld applicator. Low-dose-rate to high-dose-rate prescription conversions and depth-dose determinations were performed. Radiation safety was evaluated based on live exposure rates during assembly and surgeries. Clinical data for radiation safety, treatment tolerability, and local control was collected.
Practice parameters for the medical physicist, radiation oncologist, and ophthalmic surgeon were defined. Device sterilizations, calibrations, assemblies, surgical methods, and disposals were reproducible and effective. Treated tumors included iris melanoma, iridociliary melanoma, choroidal melanoma, and a locally invasive squamous carcinoma. Mean calculated Y disc activity was 14.33 mCi (range 8.8-16.6), prescription dose 27.8 Gy (range 22-30), delivered to depth of 2.3 mm (range 1.6-2.6), at treatment durations of 420 s (7.0 min, range 219 s-773 s). Both insertion and removal were performed during one surgical session. After surgery, each disc-applicator- system was contained for decay in storage. Treatments were well-tolerated.
HDR Y episcleral brachytherapy devices were created, implementation methods developed, and treatments performed on 6 patients. Treatments were single-surgery, rapid, and well-tolerated with short-term follow up.
在此，我们研究医学物理学家、放射肿瘤学家和眼科外科医生是否可以使用高剂量率（HDR）钇-90（Y）近距离放射治疗。
钇-90（Y）发射β射线的近距离放射治疗源获得了美国食品药品监督管理局的批准，用于巩膜表面治疗眼部肿瘤和良性肿物。建立了可追溯到美国国家标准与技术研究院的剂量校准以及治疗计划和靶区勾画方法。一次性使用系统包括固定在专门的多功能手持施源器内的Y盘。进行了低剂量率到高剂量率的处方转换以及深度剂量测定。基于组装和手术过程中的实时暴露率评估了辐射安全性。收集了辐射安全性、治疗耐受性和局部控制的临床数据。
定义了医学物理学家、放射肿瘤学家和眼科外科医生的操作参数。设备消毒、校准、组装、手术方法和处置具有可重复性且有效。治疗的肿瘤包括虹膜黑色素瘤、虹膜睫状体黑色素瘤、脉络膜黑色素瘤和局部浸润性鳞状细胞癌。计算得出的Y盘平均活度为14.33毫居里（范围8.8 - 16.6），处方剂量为27.8戈瑞（范围22 - 30），在420秒（7.0分钟，范围219秒 - 773秒）的治疗时间内，照射深度为2.3毫米（范围1.6 - 2.6）。插入和取出均在一次手术过程中完成。手术后，每个盘 - 施源器系统被收纳以便在储存中衰变。治疗耐受性良好。
创建了高剂量率Y巩膜近距离放射治疗设备，开发了实施方法，并对6例患者进行了治疗。治疗为单次手术，快速且耐受性良好，随访时间短。
