Disease control and toxicity outcomes using ruthenium eye plaque brachytherapy in the treatment of uveal melanoma

Abstract

PurposeRuthenium-106 (106Ru) eye plaques have the potential to achieve excellent tumor control with acceptable radiation toxicity. We evaluated our experience in the management of uveal melanoma treated with 106Ru brachytherapy. Methods and materialsThe records of 40 patients with uveal melanoma treated with brachytherapy using 106Ru plaques from 2003 to 2007 at University of Texas MD Anderson Cancer Center were reviewed. Endpoints assessed included tumor control and toxicity. ResultsMedian ophthalmologic follow-up was 67 months. Actuarial 5-year rates of local control (LC), progression-free survival (PFS), and overall survival (OS) were 97%, 94%, and 92%. There were 3 deaths, 2 related to melanoma. Fifteen patients experienced clinically significant visual loss; no patients were diagnosed with neovascular glaucoma, and 1 patient developed a clinically significant radiation-associated cataract. No patient required enucleation. ConclusionsWe report the largest published US cohort of patients treated with 106Ru plaque brachytherapy for uveal melanoma. Tumor control was excellent, and toxicity was acceptably low. These data support the reintroduction of 106Ru into clinical practice for ocular melanoma.