title: Tumour regression of uveal melanoma after ruthenium-106 brachytherapy or stereotactic radiotherapy with gamma knife or linear accelerator.
abstract: OBJECTIVE
  This study assesses differences in relative tumour regression and internal acoustic reflectivity after 3 methods of radiotherapy for uveal melanoma: (1) brachytherapy with ruthenium-106 radioactive plaques (RU), (2) fractionated high-dose gamma knife stereotactic irradiation in 2-3 fractions (GK) or (3) fractionated linear-accelerator-based stereotactic teletherapy in 5 fractions (Linac).
  
  
  METHODS
  Ultrasound measurements of tumour thickness and internal reflectivity were performed with standardised A scan pre-operatively and 3, 6, 9, 12, 18, 24 and 36 months postoperatively. Of 211 patients included in the study, 111 had a complete 3-year follow-up (RU: 41, GK: 37, Linac: 33). Differences in tumour thickness and internal reflectivity were assessed with analysis of variance, and post hoc multiple comparisons were calculated with Tukey's honestly significant difference test.
  
  
  RESULTS
  Local tumour control was excellent with all 3 methods (>93%). At 36 months, relative tumour height reduction was 69, 50 and 30% after RU, GK and Linac, respectively. In all 3 treatment groups, internal reflectivity increased from about 30% initially to 60-70% 3 years after treatment.
  
  
  CONCLUSIONS
  Brachytherapy with ruthenium-106 plaques results in a faster tumour regression as compared to teletherapy with gamma knife or Linac. Internal reflectivity increases comparably in all 3 groups. Besides tumour growth arrest, increasing internal reflectivity is considered as an important factor indicating successful treatment.
authors.affiliation: Department of Ophthalmology, Medical School, University of Vienna, Vienna, Austria. michael.georgopoulos@akh-wien.ac.at
authors.forename: Michael
authors.initials: M
authors.lastname: Georgopoulos
authors.forename: Martin
authors.initials: M
authors.lastname: Zehetmayer
authors.forename: Irene
authors.initials: I
authors.lastname: Ruhswurm
authors.forename: Sabine
authors.initials: S
authors.lastname: Toma-Bstaendig
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Ségur-Eltz
authors.forename: Stefan
authors.initials: S
authors.lastname: Sacu
authors.forename: Rupert
authors.initials: R
authors.lastname: Menapace
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D006801:Humans; D008545:Melanoma / Q000532:radiotherapy* / Q000601:surgery*; D008875:Middle Aged; D016634:Radiosurgery / Q000379:methods*; D012074:Remission Induction; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*
chemical_list: D012429:Ruthenium Radioisotopes