Transpupillary thermotherapy of choroidal melanoma

A retrospective analysis of the immediate and long-term effectiveness of the treatment of the choroidal melanoma using transpupillary thermotherapy (TTT) was carried out. The study included 84 patients with choroidal melanoma (C69.3) who received treatment between 2007 and 2018. Patients were sampled from the Belarusian Cancer Register. The average values of the thickness of the tumor were 2.6±1.3 mm, the diameter of the base - 7.2±3.3 mm. TTT was carried out using a diode laser with a wavelength of 860 nm and radiation power of 200 - 800 mW, the exposure time was 60 s, and the diameter of the laser spot was varied between 1 and 3 mm. The entire surface of the tumor was thermally treated with overlapping fields from the periphery to the top. 75 patients underwent a single session of TTT, while 9 - two sessions with an interval of 3–4 weeks. As a result of the treatment, 51 (60.7%) patients showed complete tumor resorption, 28 (33.3%) patients had stabilization of the tumor process, and 5 (6.0%) patients had no effect. In the group of patients with stabilization of the tumor process, continued growth was recorded in 16 (19.1%) patients with follow-up periods of 3 months to 4 years. In 19 (37.3%) patients from the group with complete tumor regression, relapse was observed 1 to 8 years after TTT. Metastatic disease (disease progression) developed in 5 (5.9%) patients, of which in 1 patient during the first 12 months, in 1 patient - after 4 years, and in 3 patients more than after 5 years of the follow-up observation. Analysis of the effectiveness of TTT of choroidal melanoma showed that an increase in the thickness and diameter of the base of the tumor focus results in the decrease of immediate effectiveness, and the rise of the likelihood of continued tumor growth.

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Long-term Choroidal Vascular Changes after Iodine Brachytherapy versus Transpupillary Thermotherapy for Choroidal Melanoma

European Journal of Ophthalmology ◽

10.1177/112067210901900420 ◽

2009 ◽

Vol 19 (4) ◽

pp. 646-653 ◽

Cited By ~ 5

Author(s):

Elisabetta Pilotto ◽

Stela Vujosevic ◽

Valentina De Belvis ◽

Raffaele Parrozzani ◽

Barbara Boccassini ◽

...

Keyword(s):

Vascular Remodeling ◽

Choroidal Melanoma ◽

Vascular Wall ◽

Primary Treatment ◽

Vascular Changes ◽

Transpupillary Thermotherapy ◽

Iodine 125 ◽

Choroidal Vessels

Purpose To compare long-term choroidal vascular changes after iodine-125 brachytherapy (IBT) versus transpupillary thermotherapy (TTT) used as primary treatment of small choroidal melanoma. Methods Ninety-five small choroidal melanomas were randomized: 49 eyes with TTT and 46 eyes with IBT alone. Fluorescein and indocyanine green angiography (ICGA) were performed at 3-month intervals during the first year, and every 6 months thereafter. Results Mean follow-up was 56.2 months (range, 24–118 months; SD, 22.6). Tumor regressed in 45 (92%) TTT-treated vs 45 (98%) IBT-treated eyes (p=0.397). Four TTT-treated and one IBT-treated tumor recurred. Occlusion of choriocapillaris was present in all TTT and IBT cases. Closure of medium and large choroidal vessels was observed in 17 (35%) TTT-treated vs 44 (96%) IBT-treated eyes (p<0.001). Choroidal vascular remodeling was detected in 20 (41%) TTT-treated and 16 (35%) IBT-treated eyes (p=0.693). Retinochoroidal anastomosis was present in 4 of the 37 (11%) TTT-treated eyes with patency of medium and large choroidal vessels, but never observed in the IBT-treated eyes, and was associated with tumor recurrence. Among IBT-treated eyes, segments of choroidal vascular wall ICG staining and choroidal aneurysmal changes were detected in 30 (65%) and 7 (15%), respectively. These changes were never detected in TTT-treated cases (p<0.0001 and p=0.015, respectively). Conclusions The pattern of tumor choroidal vascular changes following IBT and TTT differs. TTT is less effective in closing all tumor vasculature. The role of long-term choroidal vascular remodeling observed after these two treatments needs longer follow-up.

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Transpupillary laser thermotherapy of retinoblastoma

Russian Journal of Pediatric Hematology and Oncology ◽

10.21682/2311-1267-2021-8-3-43-49 ◽

2021 ◽

Vol 8 (3) ◽

pp. 43-49

Author(s):

A. A. Yarovoy ◽

D. P. Volodin ◽

V. A. Yarovaya ◽

T. L. Ushakova ◽

E. S. Kotova ◽

...

Keyword(s):

Tumor Regression ◽

Vitreous Hemorrhage ◽

Transpupillary Thermotherapy ◽

Complete Tumor Regression ◽

Application Mode ◽

Local Methods ◽

Small Primary ◽

The Mean ◽

Complete Tumor

Introduction. Despite the fact that transpupillary thermotherapy (TTT) is one of the main local methods of small retinoblastoma (RB) destruction, only a few studies have been published on the use of this method, and they are devoted only to certain aspects of the application of TTT.Purpose of the study – to evaluate the effectiveness of TTT in the treatment of children with RB.Material and methods. In the period from 2011 to 2020, 177 children (224 eyes, 1156 tumors) with RB were treated by TTT. Of these, 99 (56 %) patients were boys, 78 (44 %) – girls. The mean age at the time of treatment was 16.8 months (from 0 to 86 months). Bilateral RB was observed in 128 (72.3 %) patients, monolateral – in 49 (27.7 %). In 51 (28.8 %) cases, TTT was performed on an only eye. TTT was performed on eyes that had RB of groups A (n = 43; 19 %), B (n = 81; 36 %), C (n = 31; 14 %), D (n = 63; 28 %), E (n = 6; 3 %). In total, 1156 tumors were treated by TTT. 488 (42 %) tumors were localized post-equatorially (of which 27 were located juxtapapillary, 23 – in the macular zone, 22 – paramacular). 668 (58 %) foci had pre-equatorial localization (on the middle and far periphery of the fundus). The number of foci in one eye varied from 1 to 48 (mean – 5). The mean tumor thickness was 1.1 mm (from 0.2 to 4.5), the mean base diameter was 2.2 mm (from 0.3 to 13.4). TTT was performed using a diode laser with the following parameters: wavelength – 810 nm, spot diameter – 1200 microns, power from 200 to 800 mW (mean – 350 mW), exposure-from 3 to 15 s in the application mode, and continuous in the scanning mode.Results. Complete tumor regression after TTT was achieved in 92 % of cases (1064 tumors). Incomplete regression of the tumor with stabilization was achieved in 0.7 % (8 tumors). The average number of TTT sessions to achieve full regression was 1.7 (from 1 to 10). Complete tumor regression after 1 TTT session was achieved in 54 % of cases (622 tumors), after 2 sessions – in 11 % (132 tumors), after 3 sessions – in 7 % (85 tumors), after 4 or more sessions– in 19 % (225 tumors). In 7 % of cases (82 tumors), due to the progression of the tumor, other treatment methods (brachytherapy, cryotherapy, stereotactic radiosurgery) were applied. 209 (93 %) eyes were preserved. 15 (7 %) eyes were enucleated due to continued tumor growth, total retinal detachment, vitreous hemorrhage, or subatrophy of the eyeball. The mean follow-up after TTT was 35.5 months (from 3 to 112 months).Conclusion. TTT is a highly effective method of RB treatment and can be used for destruction of small primary foci of both post-equatorial and pre-equatorial localization, residual tumors after inefficiency of other local methods. TTT is also effective in the treatment of large cavitary tumors located in functionally significant areas of the retina.

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Long-term follow-up of topical 5-aminolaevulinic acid photodynamic therapy diode laser single session for non-melanoma skin cancer

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2009.09.001 ◽

2009 ◽

Vol 6 (3-4) ◽

pp. 207-213 ◽

Cited By ~ 30

Author(s):

C.S. Souza ◽

L.B.A. Felicio ◽

J. Ferreira ◽

C. Kurachi ◽

M.V.B. Bentley ◽

...

Keyword(s):

Photodynamic Therapy ◽

Skin Cancer ◽

Diode Laser ◽

Single Session ◽

Aminolaevulinic Acid ◽

Non Melanoma Skin Cancer ◽

Long Term Follow Up ◽

Melanoma Skin

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Long-term outcome of transpupillary thermotherapy as primary treatment of selected choroidal melanoma

Acta Ophthalmologica ◽

10.1111/j.1755-3768.2008.01327.x ◽

2009 ◽

Vol 87 (7) ◽

pp. 789-792 ◽

Cited By ~ 10

Author(s):

Raffaele Parrozzani ◽

Barbara Boccassini ◽

Valentina De Belvis ◽

Pietro Paolo Radin ◽

Edoardo Midena

Keyword(s):

Choroidal Melanoma ◽

Primary Treatment ◽

Transpupillary Thermotherapy ◽

Term Outcome ◽

Long Term Outcome

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STEREOTACTIC RADIOSURGERY FOR THE TREATMENT OF PRIMARY SARCOMAS AND SARCOMA METASTASES OF THE SPINE

Neurosurgery ◽

10.1227/01.neu.0000339131.28485.4a ◽

2009 ◽

Vol 64 (suppl_2) ◽

pp. A54-A59 ◽

Cited By ~ 44

Author(s):

Alan M. Levine ◽

Cardella Coleman ◽

Sylvia Horasek

Keyword(s):

Pain Relief ◽

Stereotactic Radiosurgery ◽

Tumor Regression ◽

Spinal Metastasis ◽

Definitive Treatment ◽

Complete Tumor Regression ◽

Institutional Review ◽

Spinal Sarcoma ◽

Complete Tumor

Abstract OBJECTIVE Spinal sarcomas pose unique treatment dilemmas because of the difficulty of achieving adequate surgical margins and/or delivering curative radiation doses (65 Gy) in close proximity to the spinal cord. This study used hypofractionated stereotactic radiosurgery (SRS) to deliver higher biologically effective doses to treat primary spinal sarcomas and spinal sarcoma metastases. METHODS Twenty-four patients with spinal or paraspinal sarcomas entered an Institutional Review Board-approved registry trial to evaluate SRS efficacy. They were assessed at regular intervals for pain control, disease progression, and complications for a minimum of 12 months or until death. RESULTS The median treatment dose for the spinal sarcoma lesions was 30 Gy at the 80% isodose in 3 fractions, with some variation based on tumor size, shape, and dose to adjacent critical structures. Seven patients were treated definitively; all had excellent pain relief and are alive with a mean follow-up period of 33 months. Two patients had complete tumor regression, 3 had partial regression, and 2 experienced recurrences and have been re-treated. Seven patients underwent resection and adjuvant SRS. One of 3 patients treated preoperatively had complete tumor regression, and none of the 4 patients treated postoperatively had a local recurrence with a mean follow-up period of 43.5 months. All 10 patients with sarcoma metastases to the spine (16 lesions) died, with a mean survival of 11.1 months from first spinal metastasis treatment. Complete pain relief was achieved in 8 patients, partial relief in 7 patients, and none in 1 patient. No patient developed radiation myelitis. CONCLUSION These preliminary results suggest that SRS may have a role in the definitive treatment of patients with primary spinal sarcomas who are deemed unresectable and as adjuvant treatment in those undergoing surgery and for palliation of sarcoma metastases.

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Neoadjuvant chemotherapy for locally advanced colon cancer patients: Long-term results from a single institutional experience.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e15598 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e15598-e15598

Author(s):

Lucia Ceniceros ◽

Carlos Pastor ◽

Carlos Sanchez-Justicia ◽

Carolina Arean ◽

Jorge Baixauli ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Tumor Regression ◽

Locally Advanced ◽

Haematological Toxicity ◽

Median Number ◽

Clinical Staging ◽

Long Term Results ◽

Long Term Outcome

e15598 Background: Neoadjuvant chemotherapy (NAC) is an emerging alternative in the management of patients with locally advanced colorectal cancer (LACRC), with promising results in terms of R0 resection rates, compliance, postoperative morbidity and a trend towards reduced risk of relapse. However, more mature data are required. We evaluated the long-term outcome of this strategy in our institution. Methods: We retrospectively analysed LACRC patients treated preoperatively with either biweekly FOLFOX or XELOX at standard doses as a follow-up of our previous experience with this neoadjuvant approach. Patients were identified from a prospectively collected tumor registry database from our institution. Clinical staging was based on colonoscopy and CT-scan. Only patients with radiological signs of lymph node involvement and/or extramural invasion > 5 mm were included. The uracil/dihidrouracil ratio was calculated at baseline as a surrogate marker of DPD deficiency. Pathological tumor regression was graded according to the MSKCC and toxicity with the NCI-CTCAE 4.0. Results: From February 2006 to November 2019 91 pts with MSS LACRC (M/F: 62/29; median age 66. Clinical stage; T3: 60.4%, T4: 37.4%, N+: 75.8%; Sideness: 82.4% left located were analysed. Preoperative chemo was FOLFOX in 46 pts and CAPOX in 45 pts. Median number of preoperative cycles was 4 (range 1-10). Side effects profile included G3-4 diarrhea (3.3%), G2 sensitive neuropathy (12.1%) and G2 neutropenia (4.4%). 9 pts had a treatment delay due to haematological toxicity. No progressive disease was noted during neoadjuvant chemotherapy. All patients underwent surgery, most of them (63.7%) by a laparoscopic approach. pCR was found in 11 pts (12.1%). Grade 3, 3+ and 4 tumor regression according to MSKCC score was reached in 50.5% of the patients (Median number of harvested nodes was 17 (range 7-51), with 75.8% being ypN0. Lymphovascular and perineural invasion were found in 7.7% and 6.6% of the patients, respectively. The median hospital stay was 7 days (3-36) and 13 pts develop any surgical complication. 37.4% received adjuvant treatment. After a median follow-up of 63 months, median progression-free (PFS) and overall survival (OS) have not been reached. 5-year actuarial PFS for right and left LACRC was 77 and 87%, respectively. Conclusions: Our data add to the growing evidence suggesting that NAC may play a meaningful role in LACRC patients

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The Triple Combination of the CD20 Antibody Obinutuzumab with the Bcl-2 Inhibitor Venetoclax (GDC-199) and the MDM2 Inhibitor Idasanutlin Results in Superior Efficacy and Long Term Response in Wildtype p53 NHL Tumor Models

Blood ◽

10.1182/blood.v128.22.4178.4178 ◽

2016 ◽

Vol 128 (22) ◽

pp. 4178-4178 ◽

Cited By ~ 2

Author(s):

Frank Herting ◽

Thomas Friess ◽

Pablo Umaña ◽

Middleton Steven ◽

Christian Klein

Keyword(s):

Tumor Regression ◽

Triple Combination ◽

Employment Equity ◽

Xenograft Models ◽

Equity Ownership ◽

Cd20 Antibody ◽

Term Response ◽

Mdm2 Inhibitor ◽

Complete Tumor

Abstract Introduction: Previous preclinical studies have shown that the CD20 antibody obinutuzumab achieved greater anti-tumor efficacy together with the Bcl-2 inhibitor venetoclax (GDC-199) (Sampath et al, Blood 122 (21), 4412), and the MDM2 inhibitor idasanutlin (RG7388) (Herting et al., Blood 124 (21), 1780). Clinical combination studies combining obinutuzumab with venetoclax (NCT01685892) or idasanutlin (NCT02624986) are currently ongoing. Based on the data we investigated whether the triple combination of obinutuzumab with venetoclax and idasanutlin can further improve outcome in two preclinical human wildtype p53 NHLtumor xenograft models. Experimental Methods: The in vivo antitumor efficacy of the triple combination and the respective double combinations and monotherapies was evaluated in two different CD20 positive p53 wildtype xenograft models in female SCID beige mice bearing established s.c. human DoHH-2 diffuse large B cell lymphoma (DLBCL) or human Z-138 mantle cell lymphoma (MCL) tumors. In the DoHH-2 model, mice were treated when tumors reached 200 mm3 with vehicle control, obinutuzumab (ip, 10 mg/kg, q7d, days 13, 21, 27), idasanutlin (po, 30 mg/kg, days 13-17, 20-24, 27-29) or venetoclax (po, 100 mg/kg, days 13-29). One study group received the triple combination at the indicated days. In the Z-138 model, mice were treated when the tumors reached 500 mm3 with vehicle control, a sub-optimal dose of obinutuzumab (ip, 0.5 mg/kg, q7d, days 18, 25, 32), idasanutlin (po, 100 mg/kg, days 18-22, 80 mg/kg days 25-36) or venetoclax (po, 100 mg/kg, daily, days 18-36). In the combination groups, obinutuzumab, idasanutlin and venetoclax were administered at the same dosages and on the same days. Results: In the DoHH-2 model all monotherapies resulted in significant anti-tumor efficacy with 56% tumor growth inhibition (TGI) for idasanutlin (npTCR 0.48, CI 0.33-0.68), 60% TGI for venetoclax (npTCR 0.43, CI 0.27-0.67) and a TGI of 90% for obinutuzumab (npTCR 0.17, CI 0.08-2.24). Superior efficacy compared to the respective monotherapies was observed for the triple combination group which induced tumor regression in 90% of the animals with 30% reaching complete tumor remission (npTCR 0.009, CI 0.00-0.02). In the Z-138 model monotherapy treatment using obinutuzumab, venetoclax or idasanutlin resulted in TGI of 47 % (npTCR 0.56, CI 0.42 - 0.76), 53% (npTCR 0.50, CI 0.40 - 0.64) or 67% (npTCR 0.43, CI 0.32 - 0.55), respectively. Combination of obinutuzumab with venetoclax or idasanutlin yielded a TGI of 85% (npTCR 0.26, CI 0.20 - 0.34) or 86% (npTCR 0.26, CI 0.19 - 0.35), respectively. Combination of idasanutlin with venetoclax and the triple combination showed tumor regression (TGI>100%) on day 32. To elucidate the long term effects a time-to-event (TTE) analysis was performed until study termination on day 125. Whereas, monotherapy with obinutuzumab at the suboptimal dose of 0.5 mg/kg resulted in 2/10 and the combination of idasanutlin and venetoclax in 5/10 tumor-free animals, the triple combination resulted in a complete tumor remission in 10/10 animals until study termination on day 125. Conclusions: These preclinical data demonstrate a strong anti-tumoral efficacy of combining the CD20 antibody obinutuzumab with the Bcl-2 inhibitor venetoclax and the MDM2 inhibitor idasanutlin, in particular regarding complete tumor remissions and long term response, and support the clinical investigation of this triple combination for the treatment of B cell malignancies. Disclosures Herting: Roche: Employment, Equity Ownership, Patents & Royalties: Roche. Friess:Roche: Employment, Equity Ownership, Patents & Royalties: Roche. Umaña:Roche: Employment, Equity Ownership, Patents & Royalties. Steven:Roche: Employment, Equity Ownership. Klein:Roche: Employment, Equity Ownership, Patents & Royalties.

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