Tumour regression of uveal melanoma after ruthenium-106 brachytherapy or stereotactic radiotherapy with gamma knife or linear accelerator.
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.
Georgopoulos
Michael
M
Department of Ophthalmology, Medical School, University of Vienna, Vienna, Austria. michael.georgopoulos@akh-wien.ac.at
Zehetmayer
Martin
M
Ruhswurm
Irene
I
Toma-Bstaendig
Sabine
S
Ségur-Eltz
Nikolaus
N
Sacu
Stefan
S
Menapace
Rupert
R
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*
D012429:Ruthenium Radioisotopes