Low-dose-rate ophthalmic brachytherapy at the Instituto Nacional de Cancerología, E.S.E.
DOI:
https://doi.org/10.32685/2590-7468/invapnuclear.4.2020.532Keywords:
Episcleral brachytherapy, iodine-125, intraocular tumors, uveal melanoma, retinoblastoma
Downloads
How to Cite
Issue
Section
Published
Abstract
Low-dose-rate brachytherapy (LDR), a cancer treatment option at the Instituto Nacional de Cancerología (INC), is a modality that uses ionizing radiation to destroy malignant cells and reduce tumor size. This treatment technique consists of the application of seeds of iodine-125 (125I), a radioactive element. In pediatric patients with early-stage uveal body melanomas and retinoblastomas, as an alternative therapy to enucleation (complete removal of the eyeball), these seeds are placed on a gold metallic plate that is surgically positioned on the surface of the eyeball in contact with the tumor to achieve optimal local control. This article describes the technique used in the INC, which has been implemented since 2006 using BEBIG Plaque Simulator software. A scan of the eyeball anatomy is created, and physical characteristics of the 125I radionuclide, the clinical procedure, the technique, dosimetric planning and radiological protection are considered. Finally, certain topics are discussed in the conclusions.
References
E. R. Simpson et al., “The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma”, Brachytherapy, vol. 13, n.° 1, pp. 1-14, 2014. http://dx.doi.org/10.1016/j.brachy.2013.11.008
B. Aragonés Cruz y M. Marín Valdés, “Resultados de la aplicación de braquiterapia en el melanoma de coroides”, Revista Cubana de Oftalmología, vol. 16, p. 5, 2006.
Y. Muiños, M. A. Saornil, A. Almaraz, F. López Lara, J. M. Frutos y M. F. Muñoz, “Estudio de la conservación del globo ocular con un abordaje multiterapéutico en el melanoma uveal ocular”, Archivos de la Sociedad Española de Oftalmología, vol. 84 n.° 3, pp. 145-150, 2009.
D. J. Bell y M. W. Wilson, “Choroidal melanoma: Natural history and management options”, Cancer Control, vol. 11, n.° 5, pp. 296-303, 2004. http://dx.doi.org/10.1177/107327480401100503
B. S. Hawkins y Collaborative Ocular Melanoma Study Group, “The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma II: initial mortality findings
COMS report no. 10”, American Journal of Ophthalmology, vol. 125, n.° 6, pp. 779-796, 1998. http://dx.doi.org/10.1016/s0002-9394(98)00039-7
L. M. Jampol et al., “The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: IV. Local
treatment failure and enucleation in the first 5 years after brachytherapy. COMS report no. 19”, Ophthalmology, vol. 109, n.° 12, pp. 2197-2206, 2002. http://dx.doi.org/10.1016/s0161-6420(02)01277-0
B. S. Hawkins, “The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma”, Arch. Ophthalmol., vol. 124, n.° 12, p. 1684, 2006. https://doi.org/10.1016/S0161-6420(02)01277-0
D. Chassagne, A. Dutreix, P. Almond, J. M. V. Burgers, M. Busch y C. A. Joslin, “Report 38”, Journal of the International Commission on Radiation Units and Measurements, vol. 20, n.° 1, 1985. https://doi.org/10.1093/jicru/os20.1.Report38.
E. Stöckel, M. Eichmann, D. Flühs, H. Sommer, E. Biewald, N. Bornfeld, B. Spaan y W. Sauerwein, “Dose distributions and treatment margins in ocular brachytherapy with 106Ru eye plaques”, Ocular Oncology and Pathology, vol. 4, n.° 2, pp. 122-128, 2018. https://doi.org/10.1159/000479558
D. M. Pérez, “La dosis radiobiológica en el tratamiento del melanoma de úvea posterior con braquiterapia epiescleral”, tesis de doctorado, Universidad de Valladolid, 2018.
S. Valverde Almohalla, B. Díaz Vega, J. M. Tomás, S. Pedro y J. L. Encinas Martín, “Braquiterapia con hilos extraesclerales de iridio-192 en melanomas uveales posteriores: resultados a largo plazo”, Oncología, vol. 28,
n.° 9, pp. 11-21, 2005. https://doi.org/10.4321/S0378-48352005000900002
R. M. Thomson, K. M. Furutani, T. W. Kaulich, F. Mourtada, M. J. Rivard, C. G. Soares, F. M. Vanneste y C. S. Melhus, “AAPM recommendations on medical physics practices for ocular plaque brachytherapy: Report of Task Group 221”, Medical Physics, vol. 47, n.° 5, pp. e92-e124, 2020. https://doi.org/10.1002/mp.13996
J. M. Mariño, “Análisis dosimétrico de la técnica de braquiterapia oftálmica de baja tasa de dosis (LDR) con placas epiesclerales de 125 I”, tesis de maestría, Universidad Nacional de Colombia, 2012.
R. Correa, “Braquiterapia epiescleral en el melanoma de coroides”, tesis de doctorado, Universidad de Málaga, 2008.
I. Puusaari, J. Heikkonen y T. Kivelä, “Ocular complications after iodine brachytherapy for large uveal melanomas”, Ophthalmology, vol. 111, n.° 9, pp. 1768-1777, 2004. https://doi.org/10.1016/j.ophtha.2004.03.027
C. L. Shields, M. Naseripour, J. Cater, J. A. Shields, H. Demirci, A. Youseff y J. Freire, “Plaque radiotherapy for large posterior uveal melanomas (≥ 8-mm thick) in 354 consecutive patients”, Ophthalmology, vol. 109, n.° 10, pp. 1838-1849, 2002. https://doi.org/10.1016/S0161-6420(02)01181-8
I. Aerts, L. Lumbroso Le Rouic, M. Gauthier Villars, H. Brisse, F. Doz y L. Desjardins, “Retinoblastoma”, Orphanet Journal of Rare Diseases, vol. 1, n.° 1, p. 31, 2006. https://doi.org/10.1186/1750-1172-1-31
D. H. Abramson, “Retinoblastoma: Diagnosis and management”, CA: A Cancer Journal for Clinicians, vol. 32, n.° 3, pp. 130-140, 1982. https://doi.org/10.3322/canjclin.32.3.130
A. Allisy, W. A. Jennings, A. M. Kellerer, J. W. Müller, H. H. Rossi y S. M. Seltzer, “Report 60”, Journal of the International Commission on Radiation Units and Measurements, vol. 31, n.° 1, 1998. https://doi.org/10.1093/jicru/os31.1.Report60
P. Andreo, D. T. Burns, A. E. Nahum, J. Seuntjens y F. H. Attix, Fundamentals of Ionizing Radiation Dosimetry, vol. 2, Wiley, 2017.
J. M. Mariño, “Protocolo para la planificación y administración de tratamientos de braquiterapia oftálmica”, Instituto Nacional de Cancerología, Bogotá, p. 104, 2011.
J. T. Parsons, F. J. Bova, W. M. Mendenhall, R. R. Million, and C. R. Fitzgerald, “Response of the normal eye to high dose radiotherapy”, Oncology (Williston Park), vol. 10, n.° 6, pp. 837-847, 1996.
T. Kaprealian, J. Rembert, L. W. Margolis y S. S. Yom, Handbook of evidence-based radiation oncology, New York: Springer New York, 2010.
D. E. Lederer y C. Edelstein, “Choroidal melanoma: Clinical presentation and differential diagnosis”, Canadian Journal of Ophthalmology, vol. 39, n.° 4, pp. 358-364, 2004. https://doi.org/10.1016/s0008-182(04)80006-1
M. A. Blasi, M. G. Sammarco, A. Scupola, M. Maceroni, G. Midena y M. M. Pagliara, “Pigmented Lesions of Ocular Fundus: Clinical Aspects”, Biomedical Journal of Scientific & Technical Research (BJSTR), vol. 13, n.° 5, 2019. https://doi.org/10.26717/BJSTR.2019.13.002477
C. L. Shields, J. Manalac, C. Das, K. Ferguson y J. A. Shields, “Choroidal melanoma: Clinical features, classification, and top 10 pseudomelanomas”, Current Opinion in Ophthalmology, vol. 25, n.° 3, pp. 177-185, 2014. https://doi.org/10.1097/ICU.0000000000000041
C. L. Shields, J. Cater, J. A. Shields, A. D. Singh, M. C. M. Santos y C. Carvalho, “Combination of clinical factors predictive of growth of small choroidal melanocytic tumors”, Archives of Pathology & Laboratory Medicine, vol. 118, n.° 3, pp. 360-364, 2000. https://doi.org/10.1001/archopht.118.3.360
“Instituto de Microcirugía Ocular (IMO) | Oftalmología”. [Online]. Disponible en https://www.imo.es/es [consutado: 19-Jun-2020].
P. T. Finger, “The 7th edition AJCC staging system for eye cancer: An international language for ophthalmic oncology”, Archives of Pathology and Laboratory Medicine, vol. 133, n.° 8. pp. 1197-1198, 2009. https://doi.org/10.1043/1543-2165-133.8.1197
S. T. Chiu-Tsao, M. A. Astrahan, P. T. Finger, D. S. Followill, A. S. Meigooni, C. S. Melhus, F. Mourtada, M. E. Napolitano, R. Nath, M. J. Rivard, D. W. Rogers y R. M. Thomson, “Dosimetry of I-125 and Pd-103 COMS eye plaques for intraocular tumors: Report of Task Group 129 by the AAPM and ABS”, Medical Physics, vol. 39, n.° 10, pp. 6161-6184, 2012. https://doi.org/10.1118/1.4749933
Ministerio de Minas y Energía, Resolucion n.° 181434 de 5 de diciembre de 2002, n.° 18. 2002, p. 69.
International Atomic Energy Agency, Radiation protection and safety in medical uses of ionizing radiation. IAEA Safety Standards Series No. SSG-46, IAEA, Vienna, 2018.
ICRP, ICRP 103: Las recomendaciones 2007 de la Comisión Internacional de Protección Radiológica, España, SEPR y APCNEAN, 2007.
IAEA, “Radiation protection in brachytherapy”. [Online]. Disponible en https://www.iaea.org/resources/rpop/health-professionals/radiotherapy/brachytherapy. [Consultado: 14 sep. 2020].
L. Ramírez Patiño, M. Barnoya Pérez de Engel, N. C. Lara Molina, H. Pérez Villanueva, M. A. Ramírez Ortiz y M. A. Ramírez Ortiz, “Braquiterapia ocular en el tratamiento del retinoblastoma: Experiencia en el Hospital Infantil de México. Ocular brachytherapy in the treatment of retinoblastoma: Experience in the Hospital Infantil de México”, Revista Mexicana de Oftalmología, vol. 93, n.° 4, pp. 194-199, 2019. https://doi.org/10.24875/RMO.M19000078
