EPISCLERAL BRACHYTHERAPY IN PORTUGAL:

LESSONS LEARNED AFTER 100 PATIENTS

Abstract

PURPOSE: To evaluate the Portuguese Reference Center practice of Episcleral Brachytherapy (EBT) for uveal melanoma, with respect to local control, survival rates, metastatic rates and side effects; and compare those results with the international literature.

MATERIAL AND METHODS: Prospective and consecutive study of patients referred to the Ocular Oncology Reference Center, Coimbra treated with EBT between November 2013 and September 2018. Follow-up data was collected regarding local control, survival, distant metastasis and side effects from treatment. Analysis was performed on factors influencing treatment outcomes and radiation side-effects.

RESULTS: A total of 100 patients underwent EBT, but only 98 had a follow-up longer than 2 months.Ninety-six percent of patients achieved local control and the incidence rate of treatment failure was 2.2/100 person-years. The incidence rate of mortality was 6.0/100 person-years and for developing metastasis was 7.3/100 person-years. The most frequent radiation side-effect was cataract and the incidence rate for the development of radiation retinopathy was 31.5/100 person-years.

CONCLUSIONS: Our results demonstrate excellent clinical outcome for local control after treatment with ¹²⁵I EBT, with satisfactory overall survival and metastasis-free survival rates. The rate of ocular toxicity is acceptable, considering the high rates of local control and globe preservation. Therefore, EBT is a valid option for globe-sparing treatment in opposition to enucleation, with the advantage of better cosmetic results.