Beta-ray brachytherapy with 106Ru plaques for retinoblastoma.
OBJECTIVE
A retrospective analysis of 134 patients who received (106)Ru brachytherapy for retinoblastomas (175 tumors in 140 eyes). Treatment and follow-up were analyzed with special emphasis on tumor control organ, preservation, and late complications.


RESULTS
Treated tumors had a mean height and diameter of 3.7+/-1.4 mm and 5.0+/-2.8 disk diameters, respectively. The radiation dose values were recalculated according to the calibration standard recently introduced by the National Institute of Standards and Technology. The recalculation revealed a mean applied dose of 419 Gy at the sclera (SD, 207 Gy) and 138 Gy (SD, 67 Gy) at the tumor apex. The 5-year tumor control rate was 94.4%. Tumor recurrence was more frequent in eyes with vitreous tumor cell seeding or fish-flesh regression. The estimated 5-year eye preservation rate was 86.5%. Previous treatment by brachytherapy or external beam radiotherapy, as well as a large tumor diameter, were significant factors for enucleation. The radiotherapy-induced complications after 5 years of follow-up were retinopathy (22%), optic neuropathy (21%), and cataract (17%). These complications were significantly more frequent after prior brachytherapy or external beam radiotherapy.


CONCLUSIONS
Brachytherapy using (106)Ru plaques is a highly efficient therapy with excellent local tumor control and an acceptable incidence of side effects.
Schueler
Andreas O
AO
Department of Ophthalmology, Universitätsklinikum Essen, Essen, Germany. andreas.schueler@uni-essen.de
Flühs
Dirk
D
Anastassiou
Gerassimos
G
Jurklies
Christine
C
Neuhäuser
Markus
M
Schilling
Harald
H
Bornfeld
Norbert
N
Sauerwein
Wolfgang
W