Local tumor control after 106Ru brachytherapy of choroidal melanoma.
OBJECTIVE
To report on local tumor control after (106)Ru brachytherapy for choroidal melanoma.


METHODS
A total of 458 patients with choroidal melanoma were treated at a single institution between January 1993 and December 2001. The tumors had a median longest basal dimension of 10.6 mm and a median height of 3.2 mm. The brachytherapy was administered using a 15- or 20-mm plaque. For posterior tumors, the plaque was positioned eccentrically with its posterior edge aligned with the posterior tumor margin to reduce the radiation dose to the optic disk and fovea. A minimal scleral dose sufficient to cause visible choroidal atrophy provided a permanent ophthalmoscopic record of the distribution of choroidal irradiation. If radiotherapy to the posterior tumor was uncertain, adjunctive transpupillary thermotherapy was administered 6 months postoperatively.


RESULTS
The actuarial rates of tumor recurrence were 1%, 2%, and 3% at 2, 5, and 7 years, respectively. Local tumor recurrence correlated with the longest basal tumor dimension (Cox univariate analysis, p = 0.02, risk ratio 1.41, 95% confidence interval 1.06-1.88). Seven of the nine eyes with recurrent tumor were salvaged with additional conservative therapy.


CONCLUSIONS
The low rate of local tumor recurrence suggests that ruthenium plaque radiotherapy is effective with good case selection and if special measures are taken to ensure that the plaque is positioned correctly.
Damato
Bertil
B
Ocular Oncology Service, St. Paul's Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool, United Kingdom. Bertil@damato.co.uk
Patel
Imran
I
Campbell
Ian R
IR
Mayles
Helen M
HM
Errington
R Douglas
RD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001918:Brachytherapy / Q000379:methods*; D002830:Choroid Neoplasms / Q000517:prevention & control / Q000532:radiotherapy*; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000517:prevention & control / Q000532:radiotherapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D017211:Treatment Failure
D012429:Ruthenium Radioisotopes