Abstract
BackgroundTo evaluate 106Ruthenium Brachytherapy in management of medium sized uveal melanoma, with emphasis on 5-year outcome and toxicity.MethodsFrom April 2007 to October 2015, 39 patients with medium sized uveal melanoma were treated with 106 Ru eye plaques brachytherapy. At the time of diagnosis, the mean tumor depth was 3.7 mm (±SD:1.6 mm). The mean dose at the tumor apex was 141.4 Gy (± SD: 12.1 Gy) and 557.7 Gy (± SD: 257.3 Gy) to the sclera.ResultsMean follow-up was 69.5 months (± SD: 53.8 months). Thirty-four patients (87.1%) remained free of recurrence. Twenty-six patients (66.7%) demonstrated a complete tumor regression after a median period of 12 months (3–60 mon.). By the final examination, the visual acuity of 26 patients (66.7%) was better than 20/200, and 12 patients (30.7%) had a visual acuity better than 20/40.Retinopathy was detected in 11 patients (28.2%). After treatments only one patient (5.1%) had active vascular changes by the last examination. Moderate optic neuropathy was observed in 4 patients (10.3%). Cataract development was diagnosed in 21 patients (53.8%), and 16 patients (41%) had bilateral cataract development.Special emphasis was made on patients with larger tumors. Twelve out of the 39 patients had a tumor with a depth of 5 mm or more. There was no significant difference in local control or in side effects between both groups observed.ConclusionsOur study proved 106Ru -brachytherapy to be an excellent treatment option with regard to tumor control and preservation of the visual acuity in well-selected patients. Our data suggested that this treatment is also suitable for tumors with a depth of more than 5 mm.
Highlights
To evaluate 106Ruthenium Brachytherapy in management of medium sized uveal melanoma, with emphasis on 5-year outcome and toxicity
Plaque brachytherapy has been well accepted for decades as an efficient approach for treatment of medium sized uveal melanoma
We recently reviewed our treatments of 106Ru brachytherapy in patients with medium sized uveal melanomas from 2007 to 2015 with emphasis on 5-year outcome and toxicity
Summary
To evaluate 106Ruthenium Brachytherapy in management of medium sized uveal melanoma, with emphasis on 5-year outcome and toxicity. Plaque brachytherapy has been well accepted for decades as an efficient approach for treatment of medium sized uveal melanoma. As an organ sparing treatment, plaque brachytherapy has psychological benefits and improves quality of life (QoL) of the patients substantially. The optimization strategies of plaque brachytherapy are under discussion. Different isotopes such as 125I, 103Pd, 106Ru, 90Sr and 131Cs were used for plaque brachytherapy and the treatment concepts varied considerably between different institutes. The use of 106Ru plaque therapy is preferred in Europe and Asia. This treatment was commonly used to treat uveal melanomas with tumor depth of up to 5 mm in the world [2, 3]
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