Adjuvant Brachytherapy with Ruthenium-106 to Reduce the Risk of Recurrence of Conjunctival Melanoma after Excision

Abstract

<b><i>Introduction:</i></b> Local recurrence of conjunctival melanoma (CM) is common after excision. Local radiotherapy is an effective adjuvant treatment option, and brachytherapy with ruthenium-106 (<sup>106</sup>Ru) is one such option. Thus, herein, we aimed to describe our experience with and the clinical results of post-excision adjuvant <sup>106</sup>Ru plaque brachytherapy in patients with CM. <b><i>Methods:</i></b> Nineteen patients (8 men and 11 women) received adjuvant brachytherapy with a <sup>106</sup>Ru plaque after tumor excision. The mean adjuvant dose administered was 109 Gy (range, 80–134 Gy), and a depth of only 2.2 mm was targeted because the tumor had been excised. A full ophthalmological examination including visual acuity testing, slit-lamp examination, and indirect ophthalmoscopy was performed before therapy and at every postoperative follow-up. The mean follow-up period was 62 months (range, 2–144 months). <b><i>Results:</i></b> Three patients developed a recurrence in a nontreated area, at either the conjunctiva bulbi or the conjunctiva tarsi. None of the patients developed a recurrence in the treated area. The local control rate was 84% (16/19). <b><i>Conclusion:</i></b> <sup>106</sup>Ru plaque brachytherapy is an effective adjuvant treatment to minimize the risk of local recurrence after excision of a CM. Patients have to be followed up regularly and carefully for the early detection of recurrence.