Braquiterapia com rutênio-106 em melanomas uveais - resultados preliminares: experiência uni-institucional / Ruthenium-106 brachytherapy for uveal melanomas - preliminary results: a single institutional experience

OBJETIVO: Analisar os resultados preliminares da braquiterapia com rutênio-106 em pacientes portadores de melanomas uveais. MATERIAIS E MÉTODOS: No período de abril de 2002 a julho de 2003, 20 pacientes com diagnóstico de melanoma uveal foram tratados com braquiterapia com rutênio-106. A dose calculada no ápice tumoral variou de 55 Gy a 100 Gy. Pacientes com lesões com altura maior que 5 mm foram submetidos a termoterapia transpupilar concomitante à colocação da placa oftálmica. RESULTADOS: Quanto à localização da lesão, esta se encontrava na coróide em 75 por cento dos casos, na íris em 15 por cento e no corpo ciliar em 10 por cento dos pacientes. Com seguimento mediano de 19 meses, a sobrevida livre de progressão para a braquiterapia e para a associação com a termoterapia transpupilar foi de 69 por cento e 87 por cento, respectivamente. Observou-se redução significante da altura tumoral após o tratamento. Nenhum dos pacientes foi submetido a enucleação. CONCLUSÃO: Nossos resultados preliminares mostram que a braquiterapia com rutênio-106 é uma opção adequada para o tratamento conservador de melanomas uveais em termos de controle local, manutenção do globo ocular e visão útil, com índice aceitável de complicações.

OBJECTIVE: To analyze the early response of uveal melanomas in patients treated with ruthenium-106 brachytherapy. MATERIALS AND METHODS: In the period between April 2002 and July 2003, 20 patients diagnosed with uveal melanoma were submitted to ruthenium-106 brachytherapy. The calculated dose delivered at the apex of the tumor ranged between 55 Gy and 100 Gy. Patients with lesions greater than 5 mm were submitted to transpupillary thermotherapy concomitantly with ophthalmic plaque insertion. RESULTS: As regards the lesions site, 75 percent of the lesions were located in the choroid, 15 percent in the iris, and the remainder 10 percent in the ciliary body. In a median 19-month-follow-up, the progression-free survival for brachytherapy was 69 percent, and 87 percent for associated brachytherapy and transpupillary thermotherapy. A significant tumor height reduction was observed after treatment. No patient was submitted to enucleation. CONCLUSION: Our preliminary results show that ruthenium-106 brachytherapy is an appropriate method for conservative treatment of patients with uveal melanomas in terms of local management, ocular and visual acuity preservation with an acceptable complications incidence rate.

Study of radiation synovectomy using (188)Re-Sulfide in hemophilic arthritis / 中华血液学杂志

<p><b>OBJECTIVE</b>To study the effectiveness of radiation synovectomy with (188)Re-sulfide.</p><p><b>METHODS</b>Twenty rabbit models of joint synovitis were injected intra-articularly with different doses of (188)Re-sulfide from 7.4 to 37.0 MBq. By pathological examination, the effects of (188)Re-sulfide on synovium and cartilage were evaluated. Clinically, 10 joints of 7 cases of hemophilic arthritis with (188)Re-sulfide radiation synovectomy were performed. MRI was taken before and after the synovectomy to evaluate the treatment effects.</p><p><b>RESULTS</b>In rabbit models, when (188)Re-sulfide dose larger than 14.8 MBq, the radiation effect on synovitis was remarkable, including thinning the thickened synovium and reducing the inflammatory cells. When radio-activity dose increased to 37.0 MBq, pathological damage was noted in cartilage. Clinical trial demonstrated that radiation synovectomy by (188)Re-sulfide could reduce the frequencies of intra-articular hemorrhage. MRI showed that edema and villi reduced.</p><p><b>CONCLUSIONS</b>Radiation synovectomy using (188)Re-sulfide is effective on synovitis in hemophilic arthritis.</p>