Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review

Nisha V Shah1, Samuel K Houston1, Timothy G Murray1,2, Arnold M Markoe21Department of Ophthalmology, Bascom Palmer Eye Institute, 2Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USAPurpose: To evaluate the surgical learning curve in episceral plaque brach...

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Autores principales:	Shah NV, Houston SK, Murray TG, Markoe AM
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/b20de51a55354d8b8e508982f94b387d
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spelling	oai:doaj.org-article:b20de51a55354d8b8e508982f94b387d2021-12-02T01:27:32ZEvaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review1177-54671177-5483https://doaj.org/article/b20de51a55354d8b8e508982f94b387d2012-03-01T00:00:00Zhttp://www.dovepress.com/evaluation-of-the-surgical-learning-curve-for-i-125-episcleral-plaque--a9526https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Nisha V Shah1, Samuel K Houston1, Timothy G Murray1,2, Arnold M Markoe21Department of Ophthalmology, Bascom Palmer Eye Institute, 2Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USAPurpose: To evaluate the surgical learning curve in episceral plaque brachytherapy placement in the management of posterior uveal melanoma.Methods: A retrospective chart review of two cohorts of 250 consecutive patients undergoing plaque placement for posterior uveal melanoma from 2002 to 2004 and from 2008 to 2009 was conducted. The plaque&ndash;tumor apposition rates verified by intraoperative echography were evaluated and correlated with surgical volume over a 19-year period.Results: In an initial study of 29 consecutive patients undergoing plaque placement from January 1992 to January 1995, a suboptimal plaque placement rate of 21% (n = 29) was identified. This percentage declined to 12% (n = 100) from January 2002 to January 2004, and further declined to 4% (n = 150) from June 2008 to August 2009. The tumor&ndash;plaque apposition rates for these three groups were 79% (1992&ndash;1995), 88% (2002&ndash;2004), and 96% (2008&ndash;2009). An estimated surgical volume of 1275 cases was performed to achieve a &gt;90% precision rate for first application of primary plaque centration.Conclusion: There are challenges to mastering the precise placement of radioactive plaques for posterior uveal melanoma. We have demonstrated a significant learning curve for plaque placement techniques, and have emphasized the importance of intraoperative ultrasound in the verification of plaque placement, thus allowing for intraoperative repositioning.Keywords: intraoperative ultrasound, brachytherapy, ocular oncologyShah NVHouston SKMurray TGMarkoe AMDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 447-452 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Shah NV Houston SK Murray TG Markoe AM Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review
description	Nisha V Shah1, Samuel K Houston1, Timothy G Murray1,2, Arnold M Markoe21Department of Ophthalmology, Bascom Palmer Eye Institute, 2Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USAPurpose: To evaluate the surgical learning curve in episceral plaque brachytherapy placement in the management of posterior uveal melanoma.Methods: A retrospective chart review of two cohorts of 250 consecutive patients undergoing plaque placement for posterior uveal melanoma from 2002 to 2004 and from 2008 to 2009 was conducted. The plaque&ndash;tumor apposition rates verified by intraoperative echography were evaluated and correlated with surgical volume over a 19-year period.Results: In an initial study of 29 consecutive patients undergoing plaque placement from January 1992 to January 1995, a suboptimal plaque placement rate of 21% (n = 29) was identified. This percentage declined to 12% (n = 100) from January 2002 to January 2004, and further declined to 4% (n = 150) from June 2008 to August 2009. The tumor&ndash;plaque apposition rates for these three groups were 79% (1992&ndash;1995), 88% (2002&ndash;2004), and 96% (2008&ndash;2009). An estimated surgical volume of 1275 cases was performed to achieve a &gt;90% precision rate for first application of primary plaque centration.Conclusion: There are challenges to mastering the precise placement of radioactive plaques for posterior uveal melanoma. We have demonstrated a significant learning curve for plaque placement techniques, and have emphasized the importance of intraoperative ultrasound in the verification of plaque placement, thus allowing for intraoperative repositioning.Keywords: intraoperative ultrasound, brachytherapy, ocular oncology
format	article
author	Shah NV Houston SK Murray TG Markoe AM
author_facet	Shah NV Houston SK Murray TG Markoe AM
author_sort	Shah NV
title	Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review
title_short	Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review
title_full	Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review
title_fullStr	Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review
title_full_unstemmed	Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review
title_sort	evaluation of the surgical learning curve for i-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/b20de51a55354d8b8e508982f94b387d
work_keys_str_mv	AT shahnv evaluationofthesurgicallearningcurvefori125episcleralplaqueplacementforthetreatmentofposterioruvealmelanomaatwodecadereview AT houstonsk evaluationofthesurgicallearningcurvefori125episcleralplaqueplacementforthetreatmentofposterioruvealmelanomaatwodecadereview AT murraytg evaluationofthesurgicallearningcurvefori125episcleralplaqueplacementforthetreatmentofposterioruvealmelanomaatwodecadereview AT markoeam evaluationofthesurgicallearningcurvefori125episcleralplaqueplacementforthetreatmentofposterioruvealmelanomaatwodecadereview
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Evaluation of the surgical learning curve for I-125 episcleral plaque placement for the treatment of posterior uveal melanoma: a two decade review

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