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Association between Tumor Regression Rate and Gene Expression Profile after Iodine 125 Plaque Radiotherapy for Uveal Melanoma.
Mruthyunjaya, Prithvi; Seider, Michael I; Stinnett, Sandra; Schefler, Amy.
Afiliação
  • Mruthyunjaya P; Department of Ophthalmology, Duke University, Durham, North Carolina; Department of Radiation Oncology, Duke University, Durham, North Carolina; Department of Ophthalmology, Stanford University, Palo Alto, California. Electronic address: prithvi9@stanford.edu.
  • Seider MI; Department of Ophthalmology, Duke University, Durham, North Carolina; Department of Ophthalmology, The Permanente Medical Group, San Francisco, California; Department of Ophthalmology, Univerisity of California, San Francisco, California.
  • Stinnett S; Department of Ophthalmology, Duke University, Durham, North Carolina.
  • Schefler A; Retina Consultants of Houston, Houston, Texas; Blanton Eye Institute at Houston Methodist Hospital, Houston, Texas.
Ophthalmology ; 124(10): 1532-1539, 2017 10.
Article em En | MEDLINE | ID: mdl-28549517
ABSTRACT

PURPOSE:

Gene expression profile (GEP) testing segregates uveal melanoma (UM) into 2 main prognostic classes. It is unknown if a greater tumor regression response after iodine 125 (I125) brachytherapy correlates with class 2 GEP status. The purpose of this study was to determine whether there is a significant relationship between the rate of UM height regression and GEP classification testing after I125 plaque brachytherapy.

DESIGN:

Multicenter, retrospective cohort study.

PARTICIPANTS:

Adult UM patients treated with I125 plaque brachytherapy who had concurrent tumor biopsy at the time of surgery with a GEP test result from January 1, 2010 through June 30, 2014.

METHODS:

Baseline clinical data and GEP class assignments were obtained. The ultrasonographic tumor height was recorded at baseline and at 3, 6, 9, and 12 months and at the most recent final follow-up visits. Subanalysis of paired cases based on pretreatment ultrasound height was performed. Statistical analysis was performed using Wilcoxon rank-sum tests, the Fisher exact test, and Kaplan-Meier analysis. MAIN OUTCOME

MEASURES:

Percentage change in tumor height from baseline.

RESULTS:

A total of 353 patients were included in the study. Median follow-up was 2.1 years (range, 0.5-5.3 years). Gene expression profile status was class 1 in 247 tumors (70%) and class 2 in 106 tumors (30%). Increased patient age, larger tumor dimensions, and greater tumor thickness were associated with class 2 GEP status (P = 0.006, P < 0.001, and P < 0.001, respectively). The percentage reduction in tumor height from baseline was significantly greater in class 1 than class 2 tumors at 3 months (17.5% vs. 11.8%; P = 0.007) and 6 months (26.8% vs. 17.1%; P = 0.007), respectively, but there was no significant difference in reduction between class 1 and 2 tumors at 9 months (P = 0.26) and 12 months (P = 0.57) after treatment. Class 1A and 1B tumors showed similar reduction compared with class 2 tumors (P < 0.05).

CONCLUSIONS:

Class 1 UM tumors tend to regress more rapidly than class 2 tumors in the first 6 months after plaque radiotherapy. Class 1A and 1B tumors regress at similar rates after plaque radiotherapy.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Uveais / Braquiterapia / Genes Neoplásicos / Radioisótopos do Iodo / Proteínas de Neoplasias Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Uveais / Braquiterapia / Genes Neoplásicos / Radioisótopos do Iodo / Proteínas de Neoplasias Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article