Yttrium-90 (90Y) brachytherapy for squamous carcinoma: Treatment of the conjunctiva, cornea, and sclera
Purpose: Patients with conjunctival squamous cell carcinoma that present with persisting disease or recurrence following topical chemotherapy and/or surgery especially when invading the sclera are challenging to treat. Herein, we describe the use of high-dose-rate (HDR), FDA-cleared, yttrium-90 (90Y...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993624001671 |
| _version_ | 1826929214855577600 |
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| author | Arpita Maniar Junzo Chino Sheridan Meltsner Paul T. Finger Miguel A. Materin |
| author_facet | Arpita Maniar Junzo Chino Sheridan Meltsner Paul T. Finger Miguel A. Materin |
| author_sort | Arpita Maniar |
| collection | DOAJ |
| description | Purpose: Patients with conjunctival squamous cell carcinoma that present with persisting disease or recurrence following topical chemotherapy and/or surgery especially when invading the sclera are challenging to treat. Herein, we describe the use of high-dose-rate (HDR), FDA-cleared, yttrium-90 (90Y) plaque brachytherapy for such lesions. Observation: Three cases of invasive conjunctival squamous cell carcinoma that had exhibited a poor response or recurrence following topical chemotherapy and/or surgery are described. As treatment, HDR 90Y beta-radiation was applied to the tumor and margins for a single, continuous duration. In contrast to low-dose-rate (LDR) plaque, HDR 90Y brachytherapy did not require episcleral sutures, amniotic membrane buffering of the cornea, a Gunderson flap, outpatient dwell time, or second surgery. Radiation safety was improved by eliminating LDR-implant related post-operative radiation exposure to health care personnel, the community, family, and pets. Follow-up examination at one month revealed complete tumor resolution in all patients. At last follow-up (8, 11 and 18 months) all patients remained clinically tumor-free as confirmed by slit-lamp biomicroscopy, anterior segment optical coherence tomography, and high-frequency ultrasound imaging. There were no acute complications (e.g., corneal edema, iridocyclitis, scleropathy, keratopathy or cataract). Conclusion and Importance: 90Y brachytherapy demonstrated efficacy as a single-surgery, minimally invasive, outpatient irradiation for squamous carcinoma of the ocular surface. While short-term results were promising, long-term follow-up monitoring for side-effects and recurrence are essential. |
| first_indexed | 2025-02-17T16:02:34Z |
| format | Article |
| id | doaj.art-b53b48420b104b27896407408160c52d |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2025-02-17T16:02:34Z |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-b53b48420b104b27896407408160c52d2024-12-18T08:50:37ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-0136102157Yttrium-90 (90Y) brachytherapy for squamous carcinoma: Treatment of the conjunctiva, cornea, and scleraArpita Maniar0Junzo Chino1Sheridan Meltsner2Paul T. Finger3Miguel A. Materin4Duke University Eye Center, 2351 Erwin Road, Durham, NC, 27710, USARadiation Oncology, Duke University, North Carolina, USARadiation Oncology, Duke University, North Carolina, USAThe New York Eye Cancer Center, New York, NY, USADuke University Eye Center, 2351 Erwin Road, Durham, NC, 27710, USA; Corresponding author. Ophthalmic Oncology, Duke Eye Center, 2351 Erwin Road, Durham, NC, 27710, USA.Purpose: Patients with conjunctival squamous cell carcinoma that present with persisting disease or recurrence following topical chemotherapy and/or surgery especially when invading the sclera are challenging to treat. Herein, we describe the use of high-dose-rate (HDR), FDA-cleared, yttrium-90 (90Y) plaque brachytherapy for such lesions. Observation: Three cases of invasive conjunctival squamous cell carcinoma that had exhibited a poor response or recurrence following topical chemotherapy and/or surgery are described. As treatment, HDR 90Y beta-radiation was applied to the tumor and margins for a single, continuous duration. In contrast to low-dose-rate (LDR) plaque, HDR 90Y brachytherapy did not require episcleral sutures, amniotic membrane buffering of the cornea, a Gunderson flap, outpatient dwell time, or second surgery. Radiation safety was improved by eliminating LDR-implant related post-operative radiation exposure to health care personnel, the community, family, and pets. Follow-up examination at one month revealed complete tumor resolution in all patients. At last follow-up (8, 11 and 18 months) all patients remained clinically tumor-free as confirmed by slit-lamp biomicroscopy, anterior segment optical coherence tomography, and high-frequency ultrasound imaging. There were no acute complications (e.g., corneal edema, iridocyclitis, scleropathy, keratopathy or cataract). Conclusion and Importance: 90Y brachytherapy demonstrated efficacy as a single-surgery, minimally invasive, outpatient irradiation for squamous carcinoma of the ocular surface. While short-term results were promising, long-term follow-up monitoring for side-effects and recurrence are essential.http://www.sciencedirect.com/science/article/pii/S2451993624001671Yttrium-90HDRBrachytherapySquamousCarcinomaPlaque |
| spellingShingle | Arpita Maniar Junzo Chino Sheridan Meltsner Paul T. Finger Miguel A. Materin Yttrium-90 (90Y) brachytherapy for squamous carcinoma: Treatment of the conjunctiva, cornea, and sclera American Journal of Ophthalmology Case Reports Yttrium-90 HDR Brachytherapy Squamous Carcinoma Plaque |
| title | Yttrium-90 (90Y) brachytherapy for squamous carcinoma: Treatment of the conjunctiva, cornea, and sclera |
| title_full | Yttrium-90 (90Y) brachytherapy for squamous carcinoma: Treatment of the conjunctiva, cornea, and sclera |
| title_fullStr | Yttrium-90 (90Y) brachytherapy for squamous carcinoma: Treatment of the conjunctiva, cornea, and sclera |
| title_full_unstemmed | Yttrium-90 (90Y) brachytherapy for squamous carcinoma: Treatment of the conjunctiva, cornea, and sclera |
| title_short | Yttrium-90 (90Y) brachytherapy for squamous carcinoma: Treatment of the conjunctiva, cornea, and sclera |
| title_sort | yttrium 90 90y brachytherapy for squamous carcinoma treatment of the conjunctiva cornea and sclera |
| topic | Yttrium-90 HDR Brachytherapy Squamous Carcinoma Plaque |
| url | http://www.sciencedirect.com/science/article/pii/S2451993624001671 |
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