Abstract
The objective of the study was to evaluate the results of Ruthenium-106 (106Ru) + Rhodium-106 (106Rh) brachytherapy in uveal melanoma (UM) patients.The data for the period 2001–2018 were taken from the Belarusian Cancer Registry and medical records of patients with clinically diagnosed uveal melanoma who received treatment at the N. N. Alexandrov National Cancer Centre of Belarus. A total of 383 patients were included in the study. 106Ru + 106Rh β-ophthalmic applicators were used for brachytherapy (BT). The calculated dose to the tumor apex was 120–130 Gy, while the reduced 100–110 Gy was administered to tumors close to the optic nerve. To analyze the treatment outcomes, patients were divided into three groups based on a basal diameter of a tumor.Out of a total 383 patients, complete tumor resolution was observed in 282 (73.6 %), tumor stabilization was present in 76 (19.8 %). Continued tumor growth and tumor relapse were observed in 34 (9.13 %) and 50 (13.05 %) patients, respectively. 59 (15.1 %) patients underwent enucleation. The metastatic disease developed in 47 (12.3 %) cases. BT adverse effects were observed in 21.3 % cases. The relapse-free survival in the group of patients with a basal tumor diameter of up to 9 mm was 76.0 ± 6.3 %, which was higher than that in the groups with a large basal diameter (p = 0.002). Over a 15-year follow-up period, almost half of the patients (52.2 ± 15.6 %) with a tumor base of more than 12 mm relapsed.Considering the high rates of the continued tumor growth during treatment in patients with a basal tumor diameter of more than 12 mm, combined therapy must be used in this group.
Highlights
Uveal melanoma (UM) is a malignancy that develops from clones of uveal melano cytes [1]
In late 1990s Collaborative Ocular Melanoma Study (COMS) showed, that there was no difference in survival rates between patients after enucleation and brachytherapy [4]
We evaluated complications based on the basal tumor diameter
Summary
Uveal melanoma (UM) is a malignancy that develops from clones of uveal melano cytes [1]. The incidence of UM in Europe decreases from north to south from 2 per million per year in Spain and southern Italy to 8 per million in Norway and Denmark [2]. The mean standardized incidence rate over a 20-year study period in Belarus is 4.8 per million [3]. In late 1990s Collaborative Ocular Melanoma Study (COMS) showed, that there was no difference in survival rates between patients after enucleation and brachytherapy [4]. Since that organ-preserving orientation in the UM treatment became preferable. The choice of a treatment method depends on tumor location and size, while the patient’s opinion is taken into account [4]
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