33. Pterygium - The GEC-ESTRO Handbook of Brachytherapy

Pterygium

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THE GEC ESTROHANDBOOKOF BRACHYTHERAPY | Part II Clinical Practice Version 1 - 01/03/2023

TABLE 1 LIST OF STUDIES ABOUT ADJUVANT RADIOTHERAPY IN PTERYGIUM.

Interval Surgery/ start BT

Primary (P)/ Recurrent (R) Study type

Year of publication

Number of lesions

Dose/ Fractions*

Author

Follow-up Local control

93.8% (35 Gy scheme) and 92.3% (20 Gy scheme)

P: 100% R: 0

Viani et al. [22]

2012

216

Prospective 35 Gy/7 or 20 Gy/10 <3 days

3 years

Range from 20 Gy to 30 Gy/3

P: 87% R: 13% Prospective

Qin et al. [23]

2012

120

<6 days

10 years

100%

100% (40 Gy scheme) and 77.9% (20 Gy scheme)

P: 100% R: 0

Yamada et al. [24]

2011

95

Retrospective 40 Gy/2 or 20 Gy/1 <7 days

10 years

P: 87% R: 13% Retrospective P: 88% R: 12% Retrospective

35 Gy/7 or 35 Gy/5 <5 days 30 Gy/3 or 35 Gy/3 <2 days

Median 60 months Median 45 months Mean 18 months

Viani et al. [25]

2008

737

90%

Isohashi et al. [26]

2006

1253

90%

P: 100% R: 0

Jürgenliemk-Schulz et al. [27] 2004

86

Prospective 25 Gy/1

<1 day

93.2%

87% (30 Gy scheme) and 70% (4 0 Gy scheme) Ranging from 76.9% to 94% according to the fractionation

P: 100% R: 0

Median 2 years

Nakamatsu et al. [37]

2004

73

Prospective 30 Gy/3 or 40 Gy/4 <3 days

Range from 20 Gy to 60 Gy/1-6 Range from 7.4 Gy to 49.9 Gy/1–5

P: 37% R: 63% Retrospective

Median 49 months

Monteiro-Grillo et al. [28]

2000

100

<1 day

P: 92% R: 8%

Nishimura et al. [29]

2000

490

Retrospective

<86 days Median 61 months

88%

P: 89% R: 11% Retrospective P: 72% R: 28% Prospective

30 Gy/3 or 35 Gy/3 <2 days 27 Gy/3 or 30 Gy/3 <1 day

Median 17 months

Fukushima et al. [30]

1999

393

93.7%

6 month –7 years Median >8 years

De Keizer [31]

1998

57

100%

P: n.a. R: n.a. P: n.a. R: n.a.

Paryani et al. [32]

1994

825

Retrospective 60 Gy/6

<1 day

98.3%

Wesberry et al. [33]

1993

171

Retrospective 20 Gy/1

<1 day

Up to 17 years 92%

Range from 10 Gy to 24 Gy/1-3 Range from 30 Gy to 45 Gy/1-3

P: 84% R: 16% Retrospective

Median 2 years

Wilder et al. [34]

1992

338

<1 day

88%

P: n.a. R: n.a.

Median 13 months

Beyer [35]

1991

146

Retrospective

<1 day

87%

* The prescription dose is to the surface of the eye

14. KEYMESSAGES

• Pterygium is an ocular surface disease characterized by a wing-shaped growth of limbal and conjunctival tissue, with progressive involvement of the cornea • Risk factors for developing pterygium include demographic, environmental, and lifestyle factors. • After primary pterygium surgery there is a high risk of recurrence, therefore, adjuvant treatment after surgical excision should be considered. • The clinical outcomes of brachytherapy treatment with a beta emitter epibulbar applicator include high local control rates and low toxicity rates.