Ruthenium-106 versus iodine-125 plaque brachytherapy of 571 choroidal melanomas with a thickness of ≥5.5 mm

2019 ◽  
Vol 104 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Maria Filì ◽  
Eric Trocme ◽  
Louise Bergman ◽  
Thonnie Rose Ong See ◽  
Helder André ◽  
...  
Keyword(s):  
Cox Regression ◽  
Patient Survival ◽  
Relative Survival ◽  
Kaplan Meier ◽  
Choroidal Melanomas ◽  
Iodine 125 ◽  
Size Controlled ◽  
Disease Specific ◽  
Related Mortality ◽  
Plaque Brachytherapy

BackgroundEpiscleral brachytherapy is the most common eye-preserving treatment for medium-sized choroidal melanomas. γ-emitting iodine-125 (125I) and β-emitting ruthenium-106 (106Ru) are widely used. The latter is however generally reserved for thinner tumours (<6 mm). In this study, we compare ocular and patient survival in thicker tumours treated with the respective radioisotope.MethodsAll patients with ≥5.5 mm thick choroidal melanomas who were treated with plaque brachytherapy at a single institution between 1 November 1979 and 31 December 2015 were included (n=571). Size-controlled Cox regression HRs for postbrachytherapy enucleation, repeated brachytherapy and melanoma-related mortality were calculated, as well as Kaplan-Meier disease-specific survival and relative 10-year survival in matched subgroups.Results317 patients were treated with 106Ru and 254 with 125I. The rate of repeated brachytherapy was significantly higher among patients treated with 106Ru (8%) than with 125I (1%, p<0.001). Size-controlled Cox regression HRs for postbrachytherapy enucleation (125I vs 106Ru 0.7, p=0.083) and melanoma-related mortality were not significant (125I vs 106Ru 1.1, p=0.63). Similarly, Kaplan-Meier disease-specific and relative 10-year survival was comparable in matched groups of 5.5–7.4 mm (relative survival 106Ru 59%, 125I 56%) and ≥7.5 mm thick tumours (relative survival 106Ru 46%, 125I 44%).ConclusionsRates of repeated brachytherapy were significantly higher among patients treated with 106Ru versus 125I for thick choroidal melanomas. There were, however, no significant differences in rates of enucleation or patient survival.

scholarly journals No Gender Differences in Long-Term Survival after Brachytherapy of 1,541 Patients with Uveal Melanoma

2019 ◽  
Vol 5 (6) ◽  
pp. 432-439 ◽  
Author(s):  
Gustav Stålhammar ◽  
Thonnie Rose See ◽  
Maria Filì ◽  
Stefan Seregard
Keyword(s):  
Uveal Melanoma ◽  
Therapeutic Interventions ◽  
Term Survival ◽  
Men And Women ◽  
Kaplan Meier ◽  
Iodine 125 ◽  
Gender Based ◽  
Survival Differences ◽  
Related Mortality ◽  
Plaque Brachytherapy

Background: In several malignancies, gender-based survival differences after specific therapeutic interventions have been demonstrated. It is not known whether such differences exist after plaque brachytherapy of uveal melanoma. Methods: All patients who received brachytherapy for uveal melanoma at St. Erik Eye Hospital from November 1, 1979 through November 20, 2017 were included (n = 1,541). Retrospective data were retrieved including baseline patient and tumor characteristics, brachytherapy nuclide (ruthenium-106 or iodine-125), radiation dose, treatment duration, tumor relapses, date of metastasis, and cause of death. Results: A total of 775 men and 766 women were treated with plaque brachytherapy. There were no significant differences between the genders in baseline characteristics, treatment, or follow-up. Men and women had similar rates of tumor relapses, hazard for repeated brachytherapy (men vs. women 0.8, p = 0.47), enucleation-free survival, and survival after detection of metastasis. Five-, 10-, and 15-year melanoma-related mortality was 14, 24, and 27% for men and 15, 26, and 32% for women, respectively. There were no significant differences in hazard for melanoma-related mortality (men vs. women 0.9, p = 0.32), median Kaplan-Meier disease-specific survival (men 18.2 years, women 15.5 years, p = 0.22), or median overall survival (men 13.5 years, women 12.6 years, p = 0.60). Conclusion: There are no relevant differences between men and women in ocular or patient survival after brachytherapy for uveal melanoma.

scholarly journals American Society of Anesthesiologists physical status score as a predictor of long-term outcome in women with endometrial cancer

2019 ◽  
Vol 29 (5) ◽  
pp. 879-885
Author(s):  
Anne Maarit Kolehmainen ◽  
Annukka Pasanen ◽  
Taru Tuomi ◽  
Riitta Koivisto-Korander ◽  
Ralf Butzow ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Physical Status ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Status Score ◽  
Kaplan Meier ◽  
American Society ◽  
Disease Specific ◽  
Related Survival ◽  
Related Mortality

ObjectiveTo study the association of the American Society of Anesthesiologists (ASA) physical status score with long-term outcome in endometrial cancer.MethodsOverall, disease-specific and non-cancer-related survival were estimated using simple and multivariable Cox regression analyses and the Kaplan-Meier method.ResultsA total of 1166 patients were included in the study. Median follow-up time was 76 (range 1–136) months. All-cause and non-cancer-related mortality were increased in patients whose ASA physical status score was III (HRs 2.5 and 8.0, respectively) or IV (HRs 5.7 and 25, respectively), and cancer-related mortality was increased in patients whose score was IV (HR 2.7). Kaplan-Meier analyses demonstrated a worse overall, disease-specific and non-cancer-related survival for patients whose score was ≥III (p<0.0001 for all). Disease-specific survival was also separately analyzed for patients with stage I and stage II–IV cancer. Compared with patients whose score was ≤II, the survival was worse for patients whose score was ≥III in both subgroups of stages (p=0.003 and p=0.017 for stage I and stages II–IV, respectively). ASA physical status score remained an independent predictor of all-cause mortality (HR 2.2 for scores ≥III), cancer-related mortality (HRs 1.7 and 2.2 for scores ≥III and IV, respectively) and non-cancer related mortality (HR 3.1 for scores ≥III) after adjustment for prognostically relevant clinicopathologic and blood-based covariates. ASA physical status score also remained an independent predictor of cancer-related mortality after exclusion of patients who were at risk for nodal involvement based on features of the primary tumor but who did not undergo lymphadenectomy, and patients with advanced disease who received suboptimal chemotherapy (HRs 1.6 and 2.5 for scores ≥III and IV, respectively).ConclusionsASA physical status score independently predicts overall survival, disease-specific survival, and non-cancer-related survival in endometrial cancer.

Small choroidal melanoma: outcomes following apical height dose brachytherapy

2020 ◽  
pp. bjophthalmol-2020-316873
Author(s):  
Renato Jose Yupari ◽  
James Bena ◽  
Allan Wilkinson ◽  
John Suh ◽  
Arun Singh
Keyword(s):  
Survival Rate ◽  
Tumour Size ◽  
Choroidal Melanoma ◽  
Basal Diameter ◽  
Small Tumour ◽  
Prior Therapy ◽  
Kaplan Meier ◽  
Choroidal Melanomas ◽  
The Mean ◽  
Iodine 125

AimTo assess the outcomes of small choroidal melanoma following iodine-125 episcleral brachytherapy (apical height dose of 85 Gy).MethodsPatients with small choroidal melanoma that underwent iodine-125 episcleral brachytherapy between January 2004 and December 2017 were reviewed. Inclusion criterion for this study was the COMS small tumour size (tumour apical height of 1.0–2.5 mm and largest basal diameter (LBD) <16.0 mm). Patients that received any form of prior therapy or adjuvant transpupillary thermotherapy were excluded. Outcome measures were visual acuity (VA), recurrence, ocular survival and metastasis at 3 years. Kaplan-Meier estimation was calculated for VA, recurrence, ocular survival and survival outcome (overall and metastasis-free survival rate) at 3 years.Results161 cases of choroidal melanoma were included in this study, with the mean (SD) age of 59.6 (14.1) years, and 93 (58%) were males. The mean (SD) apical height for the tumours were 2.1 (0.4) mm and mean (SD) LBD was 8.3 (2.2) mm. The mean (SD, median) follow-up was 40.7 months (37.1, 25 months). The VA was 20/50 or better in 69%. Only one recurrence event (1%) and one enucleation event (1%) were observed. Overall survival was 97%, and no metastatic events were observed at 3 years.ConclusionSmall choroidal melanomas treated with iodine-125 episcleral brachytherapy have excellent outcomes. The majority (69%) of patients retained VA of 20/50 or better with very high local control and ocular survival rate (99.3%) with the absence of metastasis (100%).

scholarly journals Temozolomide chronotherapy in patients with glioblastoma: a retrospective single institute study

2021 ◽  
Author(s):  
Anna R Damato ◽  
Jingqin Luo ◽  
Ruth G N Katumba ◽  
Grayson R Talcott ◽  
Joshua B Rubin ◽  
...  
Keyword(s):  
Cox Regression ◽  
Patient Survival ◽  
Standard Of Care ◽  
Preliminary Evidence ◽  
Propensity Score Method ◽  
Cancer Treatments ◽  
School Of Medicine ◽  
Kaplan Meier ◽  
Restricted Mean Survival Time ◽  
Score Method

Abstract Background Chronotherapy is an innovative approach to improving survival through timed delivery of anti-cancer treatments according to patient daily rhythms. Temozolomide (TMZ) is a standard-of-care chemotherapeutic agent for glioblastoma (GBM). Whether timing of TMZ administration affects GBM patient outcome has not previously been studied. We sought to evaluate maintenance TMZ chronotherapy on GBM patient survival. Methods This retrospective study reviewed patients with newly diagnosed GBM from 1/1/2010 to 12/31/2018 at Washington University School of Medicine who had surgery, chemoradiation, and were prescribed TMZ to be taken in the morning or evening. The Kaplan Meier method and Cox regression model were used for overall survival (OS) analyses. The propensity score method accounted for potential observational study biases. The restricted mean survival time (RMST) method was performed where the proportional hazard assumption was violated. Results We analyzed 166 eligible GBM patients with a median follow-up of 5.07 years. Patients taking morning TMZ exhibited longer OS compared to evening (median OS, 95% CI =1.43,1.12~1.92 vs. 1.13,0.84~1.58 years) with a significant year 1 RMST difference (-0.09, 95% CI:-0.16~-0.018). Among MGMT-methylated patients, median OS was 6 months longer for AM patients with significant RMST differences at years 1 (-0.13, 95% CI=-0.24~-0.019) to 2.5 (-0.43, 95% CI=-0.84~-0.028). Superiority of morning TMZ at years 1, 2 and 5 (all p&lt;0.05) among all patients was supported by RMST difference regression after adjusting for confounders. Conclusions Our study presents preliminary evidence for the benefit of TMZ chronotherapy to GBM patient survival. This impact is more pronounced in MGMT-methylated patients.

scholarly journals EVALUATIONOFRENAL REPLACEMENT THERAPYQUALITY IN UKRAINE: TIME FOR ACTIONS

2015 ◽  
pp. 3-12
Author(s):  
Mykola Kolesnyk ◽  
Nadiya Kozlyuk
Keyword(s):  
Cox Regression ◽  
Patient Survival ◽  
International Perspective ◽  
Soviet Period ◽  
Kaplan Meier ◽  
Home Based ◽  
The Status ◽  
Stage Renal Disease ◽  
End Stage

Background. Little is known about the status of renal replacement therapy (RRT) in the post-Soviet period of Ukraine. We therefore investigated the epidemiology and treatment outcomes of RRT in Ukrainian patients and put the results into an international perspective. Methods. Data from the Ukrainian National Renal Registry for patients on RRT between 1 January 2010 and 31 December 2012 were selected. We calculated the incidence and prevalence of RRT per million population (pmp) and the 3-, 12- and 24-month patient survival using the Kaplan— Meier method and Cox regression Results. There were 5985prevalent patients on RRT on 31 December 2012 (131,2 pmp). Mean age was 46,5 ± 13,8 years, 56% were men and 74% received haemodialysis (HD), while peritoneal dialysis and kidney transplantation both represented 13%. The most common cause of end-stage renal disease was glomerulonephritis (51%), while only 12% had diabetes. In 2012, 1129 patients started dialysis (incidence 24,8 pmp), with 80% on HD. Mean age was 48 ± 14 years, 58% were men and 20% had diabetes. Three, 12- and 24-month patient survival on dialysis was 95,1%, 86,0% and 76,4%, respectively. The transplant rate in 2012 was 2,1 pmp. Conclusions. The incidence and prevalence of RRT and the transplantation rate in Ukraine are among the lowest in Europe, suggesting that the need for RRT is not being met. Strategies to reduce the RRT deficit include the development and improvement of transplantation and home-based dialysis programs. Further evaluation of the quality of Ukrainian RRT care is needed.

scholarly journals Povezanost ishoda transplantacije bubrega s obilježjima primatelja i darivatelja

2020 ◽  
Vol 56 (4) ◽  
pp. 537-542
Author(s):  
Ivan Neretljak ◽  
Franjo Jurenec ◽  
Mladen Knotek ◽  
Mario Sučić ◽  
Dinko Škegro ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Renal Disease ◽  
Cox Regression ◽  
Patient Survival ◽  
Network Information ◽  
Transplant Outcomes ◽  
Transplant Patients ◽  
Kaplan Meier

Aim: Although kidney transplantation is the best method of replacing renal function, there is still a need to improve long-term outcomes. The aim of this study was to determine the independent association of recipient and donor demographic factors, underlying renal disease, duration of dialysis treatment, tissue typing mismatch, and sensitization with transplant outcomes in a contemporary cohort of kidney transplant patients. Patients and methods: The study included patients who had a kidney transplantation at Clinical Hospital Merkur from June 2007 to the end of 2018. Transplant outcomes were monitored until December 31, 2019. The minimum follow-up time was 1 year. Data were collected using reports from the Eurotransplant Network Information System (ENIS) application (<a target="_blank" rel="nofollow" href="http://www.eurotransplant.org)">www.eurotransplant.org)</a>. Survival is shown by Kaplan-Meier curves. The association of survival with specific recipient and donor characteristics was analyzed by univariate and multivariate Cox regression. Results: In the period from June 2007 to the end of 2018, 480 kidneys were transplanted in 472 patients. The 10-year patient survival was 72%. Ten-year renal survival censored for the death of renal function patients was 93%. In the multivariate analysis, only recipient age at transplantation, diabetes as the cause of underlying renal disease and duration of dialysis remained independently associated with patient survival. Conclusion: Long-term graft survival is excellent after kidney transplantation. Long-term patient survival can be improved by prevention, early detection and intensive treatment of chronic diseases.

Effect of plaque brachytherapy dose and dose rate on risk for disease-related mortality in 1238 patients with choroidal melanoma

2020 ◽  
Vol 105 (1) ◽  
pp. 57-62
Author(s):  
Maria Filì ◽  
Eric Trocme ◽  
Christina Herrspiegel ◽  
Stefan Seregard ◽  
Gustav Stålhammar
Keyword(s):  
Radiation Dose ◽  
Dose Rate ◽  
Cox Regression ◽  
Tumour Size ◽  
Choroidal Melanoma ◽  
Radiation Dose Rate ◽  
Dose Rates ◽  
Quartile Group ◽  
Iodine 125 ◽  
Related Mortality

BackgroundEpiscleral brachytherapy is the most common treatment for medium-sized choroidal melanomas. Although controversial, inadequate brachytherapy dose and dose rates have at least a hypothetical implication on patient survival.MethodsAll patients who received ruthenium-106 or iodine-125 brachytherapy for choroidal melanoma at St. Erik Eye Hospital 1996 to 2016 were included (n=1238). Cox regression hazard ratios for melanoma-related mortality across deciles, quartiles and individual integers of apex radiation doses (Gy) and dose rates (Gy/hour) were calculated, adjusted for tumour size and location.ResultsThe average radiation dose at the tumour apex ranged from 73.0 Gy in the first decile to 108.6 Gy in the tenth. Decreasing apex dose by 1 Gy increments or by decile or quartile group was not associated with melanoma-related mortality (p>0.2) The average radiation dose rate at the tumour apex ranged from 0.5 Gy/hour in the first decile to 2.8 Gy/hour in the tenth. Similarly, decreasing apex dose rate by 1 Gy/hour increments or by decile or quartile groups was not associated with melanoma-related mortality (p>0.5).ConclusionThere are no increased hazards for choroidal melanoma-related mortality after brachytherapy with decreasing doses between 108.6 and 73.0 Gy, or with decreasing dose rates between 2.8 and 0.5 Gy/hour.

scholarly journals MiR-155-5p and MiR-203a-3p Are Prognostic Factors in Soft Tissue Sarcoma

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2254
Author(s):  
Thomas Greither ◽  
Franziska Koser ◽  
Hans-Jürgen Holzhausen ◽  
Antje Güttler ◽  
Peter Würl ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Cox Regression ◽  
Tumor Stage ◽  
Regression Analyses ◽  
Survival Analyses ◽  
Kaplan Meier ◽  
Patient Prognosis ◽  
Prognostic Data ◽  
Disease Specific

Soft tissue sarcoma (STS) is a heterogeneous group of rare malignancies with a five-year survival rate of approximately 50%. Reliable molecular markers for risk stratification and subsequent therapy management are still needed. Therefore, we analyzed the prognostic potential of miR-155-5p and miR-203a-3p expression in a cohort of 79 STS patients. MiR-155-5p and miR-203a-3p expression was measured from tumor total RNA by qPCR and correlated with the demographic, clinicopathological, and prognostic data of the patients. Elevated miR-155-5p expression was significantly associated with increased tumor stage and hypoxia-associated mRNA/protein expression. High miR-155-5p expression and low miR-203a-3p expression, as well as a combination of high miR-155-5p and low miR-203a-3p expression, were significantly associated with poor disease-specific survival in STS patients in the Kaplan–Meier survival analyses (p = 0.027, p = 0.001 and p = 0.0003, respectively) and in the univariate Cox regression analyses (RR = 1.96; p = 0.031; RR = 2.59; p = 0.002 and RR = 4.76; p = 0.001, respectively), but not in the multivariate Cox regression analyses. In conclusion, the oncomiR miR-155-5p and the tumor suppressor-miR miR-203a-3p exhibit an association with STS patient prognosis and are suggested as candidates for risk assessment.

Comparing Survival between Peritoneal Dialysis and Hemodialysis Treatment in Esrd Patients with Chronic Hepatitis C Infection

2010 ◽  
Vol 30 (1) ◽  
pp. 86-90 ◽  
Author(s):  
Che-Yi Chou ◽  
I-Kuan Wang ◽  
Jiung-Hsiun Liu ◽  
Hsin-Hung Lin ◽  
Shu-Ming Wang ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Propensity Score ◽  
Chronic Hepatitis C ◽  
Cox Regression ◽  
Patient Survival ◽  
Hepatitis C Infection ◽  
Kaplan Meier ◽  
B Virus ◽  
Esrd Patients

Objective End-stage renal disease (ESRD) patients with hepatitis C virus (HCV) infection are associated with an increasing mortality risk on hemodialysis (HD) and peritoneal dialysis (PD). The aim of this study was to compare patient survival between HCV-positive patients undergoing PD versus HD. Methods We reviewed 78 PD and 78 HD patients with chronic hepatitis C infection in China Medical University Hospital from 1996 to 2006. The HD patients were selected using the propensity score matching method. Kaplan–Meier analysis with log-rank test was used to compare patient survival between patients treated with PD and those treated with HD. Possible prognostic factors were analyzed using multivariate Cox proportional hazard regression with adjustments for age, sex, and propensity score. Results Mortality rate was 50% (39/78) for PD and 41% (32/78) for HD (chi-square test p = 0.26). Diabetes, hypertension, and cardiovascular disease were present in 43.6%, 25.6%, and 14.1% of patients, respectively. Kaplan–Meier estimate and univariate Cox regression with adjustments for age and propensity score showed that HCV patients treated with PD had a similar survival to those treated with HD ( p = 0.381 and p = 0.363). In forward stepwise Cox regression, positivity for hepatitis B virus surface antigen ( p < 0.001), diabetes ( p = 0.009), and serum albumin ( p = 0.032) were independently associated with higher mortality. Conclusion Patient survival is not different between ESRD patients with chronic hepatitis C treated with PD and those treated with HD. In ESRD patients positive for HCV, being positive for hepatitis B virus is an important prognostic factor.

RESULTS OF TREATMENT OF LOCALLY RECURRING SOFT TISSUES SARCOMAS OF EXTREMITIES

2018 ◽  
Vol 64 (3) ◽  
pp. 408-413
Author(s):  
Grigoriy Zinovev ◽  
Georgiy Gafton ◽  
Sergey Novikov ◽  
Ivan Gafton ◽  
Yekaterina Busko ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissues ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Tumor Location ◽  
Long Term Results ◽  
Clinical Feature ◽  
National Medical ◽  
Results Of Treatment ◽  
Kaplan Meier

Background: The most striking clinical feature of soft tissues sarcomas (STS) is their ability to recur. At present disputes about the clinical and morphological factors of STS recurrence such as the degree of malignancy, size, location, depth of tumor location, patient’s age and the presence of previous relapses in the anamnesis do not subside. It also requires clarification of the effect of the volume of tissues removed on the long-term results of treatment of STS as well as indications for the application of various regimes of remote radiation therapy. Materials and methods: Of 1802 registered cases of STS of extremities at the N.N. Petrov National Medical Research Center of Oncology from 2004 to 2016 there were selected data on 213 patients who suffered from at least one relapse of the disease. There was performed an assessment of overall, non-metastatic and disease-free survival using a single-factor (the Kaplan-Meier method) and multivariate analysis (the Cox regression model). Conclusion: The detection of various prognostic factors of locally recurrent STS allows determining the necessary treatment tactics (the vastness and traumatism of surgery and the advisability of radiation therapy).

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