Browsing by Author "Buitrago, M"

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High-risk histopathological features of retinoblastoma following primary enucleation: A Global Study Of 1,426 Patients From 5 Continents
(Lippincott Williams and Wilkins, 2024) Kaliki, S; Vempuluru, VS; Bakal, KR; Dorji, S; Tanna, V; Shields, CN; Fallon, SJ; Raval, V; Ahmad, A; Mushtaq, A; Hussain, M; Yousef, YA; Mohammad, M; Roy, SR; Huque, F; Tatiana, U; Yuri, S; Vladimir, P; Zambrano, SC; Alarcón-León, S; Valdiviezo-Zapata, C; Vargas-Martorellet, M; Gutierrez-Chira, C; Buitrago, M; Ortiz, JS; Diaz-Coronado, R; Tripathy, D; Rath, S; Patil, G; Berry, JL; Pike, S; Brown, B; Tanabe, M; Frenkel, S; Eiger-Moscovich, M; Pe'er, J; Shields, CL; Eagle, RC,, Jr; Laiton, A; Velasco, AM; Vega, K; Desimone, J; Bejjanki, KM; Kapoor, AG; Venkataraman, A; Bryant, V; Reddy, MA; Sagoo, MS; Hubbard, GB; Azarcon, CP; Olson, TA; Grossniklaus, H; Rolfe, O; Staffieri, SE; O'day, R; Mathew, AA; Elder, JE; Mckenzie, JD; Fabian, ID; Shemesh, R; Vishnevskia-Dai, V; Ali, MH; Jakati, S; Mishra, DK; Palkonda, VAR
Purpose: To evaluate high-risk histopathological features following primary enucleation of eyes with retinoblastoma and assess the patient outcomes across continents. Methods: A retrospective study of 1,426 primarily enucleated retinoblastoma eyes from five continents. Results: Of all, 923 (65%) were from Asia (AS), 27 (2%) from Australia (AUS), 120 (8%) from Europe (EUR), 162 (11%) from North America (NA), and 194 (14%) from South America (SA). Based on the continent (AS vs. AUS vs. EUR vs. NA vs. SA), the histopathological features included massive choroidal invasion (31% vs. 7% vs. 13% vs. 19% vs. 27%, P = 0.001), postlaminar optic nerve invasion (27% vs. 0% vs. 16% vs. 21% vs. 19%, P = 0.0006), scleral infiltration (5% vs. 0% vs. 4% vs. 2% vs. 7%, P = 0.13), and microscopic extrascleral infiltration (4% vs. 0% vs. <1% vs. <1% vs. 4%, P = 0.68). Adjuvant chemotherapy with/without orbital radiotherapy was given to 761 (53%) patients. Based on Kaplan-Meier estimates in different continents (AS vs. AUS vs. EUR vs. NA vs. SA), the 6-year risk of orbital tumor recurrence was 5% versus 2% versus 0% versus 0% versus 12% (P < 0.001), systemic metastasis was reported in 8% versus 5% versus 2% versus 0% versus 13% (P = 0.001), and death in 10% versus 3% versus 2% versus 0% versus 11% (P < 0.001) patients. Conclusion: There is a wide variation in the infiltrative histopathological features of retinoblastoma across continents, resulting in variable outcomes. SA and AS had a higher risk of orbital tumor recurrence, systemic metastasis, and death compared to AUS, EUR, and NA. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
Phase I/II study on kilovoltage surface brachytherapy in conjunctival cancer: preliminary results
(Cancer Intellilgence, 2018) Sarria-Bardales, GR; Sarria, GJ; Rivera, PF; Zaharia, M; Serpa, S; Buitrago, M
Introduction: In ocular conjunctival carcinoma after surgery, adjuvant treatment has a role and kilovoltage surface brachytherapy opens a new door for the range of therapeutic options. Materials and methods: Between October 2014 and June 2017, at the National Institute of Neoplastic Diseases (INEN) from Peru, 39 patients with squamous cell carcinoma of ocular conjunctiva, T1-T3, resected, were selected to receive adjuvant treatment. The portable accelerator of 50-kV INTRABEAM (Carl Zeiss Meditec) was used, after local anaesthesia and blocking of ocular muscles movement. The doses used were 18 Gy for patients with free margins and 22 Gy for positive edges, according to calculation of equivalent dose of 2Gy per fraction of 46 and 66 Gy, respectively, assuming a tumoural α/β ratio of 8 Gy. The prescription was done to 2 mm depth. Results: The median age was 69 years, distributed evenly between both genders, with a median follow-up of 12 months. The surgical margins were 59% free and 41% committed, with no difference between the institutions where the surgery was performed (P = 0.069). The median tumour size was 7 mm with 2 mm of invasion, 61.5% was T2 and 35.9% T1. The mean time between surgery and irradiation was 1.5 months, 23.1% of patients developed grade I toxicity of spontaneous resolution, without evidence of greater degree in any case. The dose had no statistical relationship with toxicity (P = 0.533). One-year disease-free survival was 96.7%. Conclusions: Kilovoltage surface brachytherapy is an applicable and reproducible tool in the treatment of squamous cell carcinoma of ocular conjunctiva. The administered doses are well tolerated by patients with low levels of acute toxicity. Longer follow-up is needed to establish disease control rates and late toxicities.