Introduction
The aim of this study was to analyze regression rates and local control of uveal melanoma patients treated with iodine-125 (125I) brachytherapy based on initial tumor apical height.

Material and methods
Patients treated in a single institution from January 1st, 1996 to 2019 with 125I plaques (ROPES and COMS) for uveal melanoma were included in this study. Patients treated with brachytherapy for iris and those treated with transpupillary thermotherapy prior to brachytherapy were excluded. The sample was classified into 4 categories depending on initial apical tumor height (h0), i.e., h0 ≤ 2.5 (small), 2.5 < h0 ≤ 6.25 (small-medium), 6.25 < h0 ≤ 10 (medium-large), and h0 > 10 mm (large). Percentage of original tumor apical height (Δh) was collected during follow-ups. Patterns of regression were evaluated using linear least squares adjustments. Multivariable Cox regression were performed.

Results
In total, 305 patients met the inclusion criteria, and 27, 166, 100, and 13 were considered for small, small-medium, medium-large, and large categories, respectively. Median follow-up was 82.4, 56.8, 76.1, 89.1, and 100.1 months for the entire cohort and each sub-group, respectively. Pattern of decrease when h0 ≤ 2.5 mm was not detectable. For the rest sub-groups, changes in height could be fitted using functional form: Δh (T) = ae–bT + c, R2 ≥ 0.97. Multivariate Cox analysis factors predictive of local control failure revealed a hazard ratio (HR) of 6.1 (95% CI: 0.7-58.2%, p = 0.05) for patients who remained similar sized after treatment for small-medium tumors. For the rest sub-groups, Cox analysis did not indicate statistical significance in any single variable.

Conclusions
: Height changes can be modeled by a negative exponential function for the first 7 years after treatment depending on the initial height, except for those less than 2.5 mm. Non-responding small-medium tumors multiply by 6 the probability of failure in local control.



中文翻译：

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基于治疗前肿瘤顶端高度的碘 125 斑块放射治疗后葡萄膜黑色素瘤的消退

 介绍

本研究的目的是根据初始肿瘤顶端高度，分析接受碘 125 (125I) 近距离放射治疗的葡萄膜黑色素瘤患者的消退率和局部控制。

 材料与方法

本研究纳入了 1996 年 1 月 1 日至 2019 年在单一机构接受 125I 斑块（ROPES 和 COMS）治疗葡萄膜黑色素瘤的患者。排除接受虹膜近距离放射治疗的患者和在近距离放射治疗之前接受经瞳孔温热治疗的患者。根据初始根尖肿瘤高度（h0）将样本分为 4 类，即 h0 ≤ 2.5（小）、2.5 < h0 ≤ 6.25（小-中）、6.25 < h0 ≤ 10（中-大）、 h0 > 10 毫米（大）。在随访期间收集原始肿瘤顶端高度（Δh）的百分比。使用线性最小二乘调整评估回归模式。进行多变量 Cox 回归。

 结果

总共有 305 名患者符合纳入标准，分别有 27 名、166 名、100 名和 13 名患者被纳入小型、中小型、中大型和大型类别。整个队列和每个亚组的中位随访时间分别为 82.4、56.8、76.1、89.1 和 100.1 个月。当 h0 ≤ 2.5 mm 时，无法检测到下降模式。对于其余子组，高度的变化可以使用函数形式来拟合：Δh (T) = ae–bT + c, R2 ≥ 0.97。预测局部控制失败的多变量 Cox 分析因素显示，对于中小肿瘤治疗后仍保持相似大小的患者，风险比 (HR) 为 6.1（95% CI：0.7-58.2%，p = 0.05）。对于其余亚组，Cox 分析未表明任何单个变量具有统计显着性。

 结论

：根据初始身高，治疗后前 7 年的身高变化可以通过负指数函数进行建模，但小于 2.5 毫米的除外。无反应的中小型肿瘤使局部控制失败的概率乘以 6。