Pregnancy and Plaque Brachytherapy Treatment of Uveal Melanoma：A Retrospective Study

Abstract Background To examine whether pregnancy affects the prognosis of uveal melanoma (UM) patients undergoing plaque brachytherapy (PBT) and if PBT has any effect on the outcome of such pregnancy. Methods We conducted a single-center retrospective study at the Beijing Tongren Hospital on the population of women with childbearing age who were diagnosed with uveal melanoma and underwent iodine-125 plaque brachytherapy. The outcome of each pregnancy and the status of the fetus was followed-up. Survival analysis were performed using Kaplan-Meier method, with the metastasis and death as endpoints. Results 13 patients with 13 full-term pregnancies and 96 non-pregnant women with matched age and tumor size were included. In pregnant group, two patients developed metastasis, one of which died shortly after delivery; local recurrence of UM occurred in 2 patients after or during delivery, and 2 other patients developed secondary glaucoma due to radiation retinopathy. None of the other pregnant patients reported any signs of disease progression. In the control group, 18 metastasis cases including 12 deaths were documented. Pregnant patients and matched control subjects showed no statistical difference in both Metastasis-free survival (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.15–2.86; P = 0.576) and overall survival (HR: 0.48, 95% CI: 0.06–3.66; P = 0.464). All pregnant patients carried the pregnancy to term and delivered healthy babies with no report of placental or infant metastases to date. Conclusion Pregnancy exerted no adverse effects on the prognosis of UM patients who receive PBT. While PBT had no significant effect on maternal fertility, and did not show teratogenic effect on the fetus so far, long-term effects require further follow-up studies.