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The Cochrane Database of Systematic... Jun 2012The outcome of glaucoma surgery can be affected by the rate at which the surgical wound heals. Beta radiation has been proposed as a rapid and simple treatment to slow... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The outcome of glaucoma surgery can be affected by the rate at which the surgical wound heals. Beta radiation has been proposed as a rapid and simple treatment to slow down the healing response.
OBJECTIVES
To assess the effectiveness of beta radiation during glaucoma surgery (trabeculectomy).
SEARCH METHODS
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 3), MEDLINE (January 1950 to March 2012), EMBASE (January 1980 to March 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 26 March 2012.
SELECTION CRITERIA
We included randomised controlled trials comparing trabeculectomy with beta radiation to trabeculectomy without beta radiation.
DATA COLLECTION AND ANALYSIS
We collected data on surgical failure (intraocular pressure > 21 mmHg), intraocular pressure and adverse effects of glaucoma surgery. We pooled data using a fixed-effect model.
MAIN RESULTS
We found four trials that randomised 551 people to trabeculectomy with beta irradiation versus trabeculectomy alone. Two trials were in Caucasian people (126 people), one trial in black African people (320 people) and one trial in Chinese people (105 people). People who had trabeculectomy with beta irradiation had a lower risk of surgical failure compared to people who had trabeculectomy alone (pooled risk ratio (RR) 0.23 (95% CI 0.14 to 0.40). Beta irradiation was associated with an increased risk of cataract (RR 2.89, 95% CI 1.39 to 6.0).
AUTHORS' CONCLUSIONS
Trabeculectomy with beta irradiation has a lower risk of surgical failure compared to trabeculectomy alone. A trial of beta irradiation versus anti-metabolite is warranted.
Topics: Beta Particles; Cataract; Combined Modality Therapy; Glaucoma; Humans; Randomized Controlled Trials as Topic; Trabeculectomy; Treatment Outcome; Wound Healing
PubMed: 22696336
DOI: 10.1002/14651858.CD003433.pub3 -
The Cochrane Database of Systematic... Apr 2009The outcome of glaucoma surgery can be affected by the rate at which the surgical wound heals. Beta radiation has been proposed as a rapid and simple treatment to slow... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
The outcome of glaucoma surgery can be affected by the rate at which the surgical wound heals. Beta radiation has been proposed as a rapid and simple treatment to slow down the healing response.
OBJECTIVES
To assess the effectiveness of beta radiation during glaucoma surgery (trabeculectomy).
SEARCH STRATEGY
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (which includes the Cochrane Eyes and Vision Group Trials Register) (Issue 4 2008), MEDLINE (January 1966 to October 2008) and EMBASE (January 1980 to October 2008). The databases were last searched on 24 October 2008.
SELECTION CRITERIA
We included randomised controlled trials comparing trabeculectomy with beta radiation to trabeculectomy without beta radiation.
DATA COLLECTION AND ANALYSIS
We collected data on surgical failure (intraocular pressure > 21 mmHg), intraocular pressure and adverse effects of glaucoma surgery. We pooled data using a fixed-effect model.
MAIN RESULTS
We found four trials that randomised 551 people to trabeculectomy with beta irradiation versus trabeculectomy alone. Two trials were in Caucasian people (126 people), one trial in black African people (320 people) and one trial in Chinese people (105 people). People who had trabeculectomy with beta irradiation had a lower risk of surgical failure compared to people who had trabeculectomy alone (pooled risk ratio (RR) 0.23 (95% CI 0.14 to 0.40). Beta irradiation was associated with an increased risk of cataract (RR 2.89, 95% CI 1.39 to 6.0).
AUTHORS' CONCLUSIONS
Trabeculectomy with beta irradiation has a lower risk of surgical failure compared to trabeculectomy alone. A trial of beta irradiation versus anti-metabolite is warranted.
Topics: Beta Particles; Cataract; Combined Modality Therapy; Glaucoma; Humans; Randomized Controlled Trials as Topic; Trabeculectomy; Treatment Outcome; Wound Healing
PubMed: 19370589
DOI: 10.1002/14651858.CD003433.pub2 -
The Oncologist Feb 2006
Topics: Beta Particles; Humans; Neoplasms; Radioactivity; Radioimmunotherapy; Radioisotopes
PubMed: 16476838
DOI: 10.1634/theoncologist.11-2-181 -
Journal of Interventional Cardiology Dec 2001This state-of-the-art review is intended to explore the development of beta radiation including catheter delivered and permanent implants from its inception to current... (Review)
Review
This state-of-the-art review is intended to explore the development of beta radiation including catheter delivered and permanent implants from its inception to current practice. Specific focus will be given to the isotopes currently available, radiation physics of beta emitters, preclinical studies, clinical trials, beta radiation delivery systems, and implications for future practice. The encouraging results from the clinical trials have established vascular brachytherapy as a standard of care for patients with in-stent restenosis. Vascular brachytherapy requires additional "fine-tuning" to achieve full optimization.
Topics: Beta Particles; Brachytherapy; Coronary Restenosis; Humans
PubMed: 12053381
DOI: 10.1111/j.1540-8183.2001.tb00378.x -
Catheterization and Cardiovascular... Jan 2021When a patient presents with restenosis and two layers of previously place drug eluting stents this is a true treatment dilemma for the interventionist. Beta radiation...
When a patient presents with restenosis and two layers of previously place drug eluting stents this is a true treatment dilemma for the interventionist. Beta radiation has proven its efficacy to decrease in-stent restenosis compared to standard PCI. No drug-coated balloons are currently available in the United States for treatment of in-stent restenosis.
Topics: Beta Particles; Brachytherapy; Coronary Restenosis; Drug-Eluting Stents; Humans; Percutaneous Coronary Intervention; Stents; Treatment Outcome
PubMed: 33460270
DOI: 10.1002/ccd.29448 -
Cardiovascular Radiation Medicine 2002Beta radiation has found increasing interest in intravascular brachytherapy for successfully overcoming the severe problem of restenosis after interventional treatment... (Review)
Review
PURPOSE
Beta radiation has found increasing interest in intravascular brachytherapy for successfully overcoming the severe problem of restenosis after interventional treatment of arterial stenosis. Prior to initiating procedures applying beta radiation there is a common need to specify methods for the determination and specification of the absorbed dose to water or tissue and their spatial distributions. The DIN-NAR standardization in radiology task group Dosimetry has initiated an international ad hoc working group for an ISO new work item proposal on the standardization of procedures in clinical beta radiation dosimetry.
METHODS
The intent of this standard is to review methods and to give recommendations for the calibration of therapeutic beta sources, a code of practice for clinical beta radiation dosimetry and guidance for estimating the uncertainty of the absorbed dose to water delivered. The standard will be confined to "scaled" radioactive sources such as single seeds, source trains, line, shell and volume sources for which only the beta radiation emitted is of therapeutic relevance. The topics will include dosimetric quantities; source data; calibration and traceability; general principles and requirements for absorbed dose measurements; in phantom dosimetry; theoretical modeling; presentation of dose distributions; clinical dosimetry; clinical quality control; irradiation treatment planning; as well as uncertainties. The document is geared to organizations wishing to establish reference methods in dosimetry aiming at clinical demands for appropriate small measurement uncertainties. Existing normative documents as well as international recommendations, such as those from AAPM, DGMP, ESTRO, NCS, ICRU, or IAEA will be taken into account.
RESULTS
The first meetings of the new international working group took place in March and September 2002 at Essen, Germany [IAEA-cn-96-73, 2002].
CONCLUSIONS
Based on the DGMP Report 16, the AAPM TG 60 up-date draft, other recommendations and normative documents, the DIN-NAR project has collected and prepared detailed material on the calibration and dosimetry of beta radiation brachytherapy sources in terms of absorbed dose to water. The ISO new work item proposal will be completed in spring 2003.
Topics: Beta Particles; Brachytherapy; Calibration; Coronary Restenosis; Humans; Practice Guidelines as Topic; Practice Patterns, Physicians'; Radiometry; Radiotherapy Dosage; Water
PubMed: 12974376
DOI: 10.1016/s1522-1865(03)00110-0 -
Radiation Research Aug 2019While cutaneous radiation injury (CRI) is generally referenced as a consequence of a nuclear attack, it can also be caused by less dangerous events such as the use of...
While cutaneous radiation injury (CRI) is generally referenced as a consequence of a nuclear attack, it can also be caused by less dangerous events such as the use of dirty bombs, industrial radiological accidents, or accidental overexposure of beta (β) particle or gamma (γ) radiation sources in medical procedures. Although the gross clinical consequences of these injuries have been well documented, relatively little is known about the molecular changes underlying the progression of pathology. Here we describe a porcine model of cutaneous radiation injury after skin was exposed to strontium-90 b particle at doses of 16-42 Gy and characterize the anatomical and molecular changes over 70 days. The results show that irradiated sites displayed dosedependent increases in erythema and moist desquamation that peaked between days 35 and 42. Dose-dependent histopathological changes were observed, with higher doses exhibiting increased inflammation and epidermal hyperplasia beyond day 35. Furthermore, immunohistochemistry showed that exposure to 37 Gy β-particle radiation decreased epidermal cell proliferation and desmosomal junction proteins at day 70, suggesting compromised epidermal integrity. Metabolomic analysis of biopsies revealed dose- and time-dependent changes as high as 252-fold in several metabolites not previously linked to CRI. These alterations were seen in pathways reflecting protein degradation, oxidative stress, eicosanoid production, collagen matrix remodeling, mitochondrial stress, cell membrane composition and vascular disruption. Taken together, these data show that exposure to high doses of β particle damaged the molecular processes underlying skin integrity to a greater extent and for a longer period of time than has been shown previously. These findings further understanding of radiation-induced skin injury and serve as a foundation for the development and testing of potential therapeutics to treat CRI.
Topics: Animals; Beta Particles; Cell Proliferation; Dose-Response Relationship, Radiation; Female; Skin; Swine; Transcriptome
PubMed: 31166846
DOI: 10.1667/RR14283.1 -
Meta-analysis of beta radiation augmentation for trabeculectomy - results in distinct ethnic groups.Arquivos Brasileiros de Oftalmologia 2011To conduct a systematic review with meta-analysis on the efficacy of trabeculectomy (TREC) followed by beta irradiation (BRT/TREC) compared to TREC alone for glaucoma in... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To conduct a systematic review with meta-analysis on the efficacy of trabeculectomy (TREC) followed by beta irradiation (BRT/TREC) compared to TREC alone for glaucoma in terms of intraocular pressure (IOP) control and adverse effects of treatment in different ethnic groups.
METHODS
A meta-analysis of randomized controlled trials (RCT) was performed comparing adjunct BRT treatment for glaucoma with standard TREC after 12 months. The MEDLINE, EMBASE, LILACS, and Cochrane Library databases, Trial registers, bibliographic databases and recent studies of relevant journals were searched. Two reviewers independently reviewed relevant reports and the references from these reports were searched for additional trials, using guidelines set by QUOROM statement criteria.
RESULTS
Of a total of 1,350 citations, eight studies (five cohorts, three randomized) were identified and only 3 RCT were included in this meta-analysis. Higher IOP reductions were verified in the BRT arm compared to the control arm (mean difference=1.68 mmHg, 95% CI= 0.61-2.68, P=0.002). Uncontrolled postoperative IOP (>21 mmHg) was less frequent when BRT was used (BRT/ TREC arm) compared to the control arm (38/218=17.4% versus 9/239=3.8%; OR=6.7; 95% CI 3.2-14.3, P<0.0001). Although better IOP control was observed in all patients treated with adjuvant BRT, only Black patients displayed a significant difference (P=0.005). There were no significant differences between the BRT and control arms regarding loss of visual acuity, postoperative complications and necessity of cataract surgery.
CONCLUSION
Adjunct BRT increases the success rate of TREC, with better results in non Caucasian patients, and does not influence the occurrence of postoperative complications.
Topics: Beta Particles; Glaucoma; Humans; Intraocular Pressure; Radiotherapy, Adjuvant; Randomized Controlled Trials as Topic; Trabeculectomy; Treatment Outcome; Visual Acuity
PubMed: 22068862
DOI: 10.1590/s0004-27492011000400016 -
Ophthalmic Plastic and Reconstructive... Dec 1994Although complications associated with the use of beta radiation after pterygium surgery can occur, the author has found the use of beta radiation to be beneficial in... (Review)
Review
Although complications associated with the use of beta radiation after pterygium surgery can occur, the author has found the use of beta radiation to be beneficial in preventing recurrences when used with pterygium surgery. An effective surgical regime of pterygium surgery is presented. A procedure made up of steps that tend to prevent revascularization of the operative site after pterygium surgery will decrease the recurrence rate. The use of strontium 90 and the mechanism of action of beta ray therapy in treatment of the pterygium is discussed. Few complications have occurred in > 200 surgically treated cases of pterygium with postoperative beta radiation administered with a strontium 90 applicator. No cases of radiation cataract have been observed.
Topics: Beta Particles; Combined Modality Therapy; Conjunctiva; Humans; Postoperative Care; Pterygium; Recurrence; Strontium Radioisotopes
PubMed: 7865444
DOI: 10.1097/00002341-199412000-00004 -
A.M.A. Archives of Ophthalmology Feb 1955
Topics: Abnormalities, Radiation-Induced; Beta Particles; Cataract; Radiation; Radium
PubMed: 13227688
DOI: 10.1001/archopht.1955.00930010250012