title: Combined brachytherapy and transpupillary thermotherapy for large choroidal melanoma: tumor regression and early complications.
abstract: BACKGROUND
  To determine the effectiveness and risk profile of combined ruthenium- (Ru)-106-brachytherapy and transpupillary thermotherapy (TTT) of the tumour apex for the treatment of large choroidal melanoma.
  
  
  METHODS
  A consecutive series of 31 large choroidal melanoma treated by Ru-106-brachytherapy and adjuvant TTT was studied. TTT was performed 1 day prior to plaque removal and up to 3 times (mean: 1.8) during follow-up. Evaluation comprised tumour regression, treatment-related adverse events, necessity of additional treatment and visual results.
  
  
  RESULTS
  Mean follow-up was 21.6+/-7.8 (10.8-38.3) months. Mean tumour thickness was 6.8+/-1.0 (5.0-8.9) mm prior to treatment. Mean residual tumour thickness at the end of follow-up was 2.5+/-1.0 mm. Relevant adverse treatment effects were exudative maculopathy or macula oedema (22.6%), vitreous haemorrhage (16.1%), optic neuropathy (16.1%) and retinal detachment (9.7%). One tumour recurrence occurred during follow-up, and was treated by enucleation.
  
  
  CONCLUSIONS
  The combination of Ru-106-brachytherapy with TTT allows for the treatment of large posterior choroidal melanoma. The rate of treatment-related adverse events appears to be acceptable.
authors.affiliation: Augen-Zentrum, DRK-Kliniken Westend, Spandauer Damm 130, 14050 Berlin, Germany. KMKreusel@aol.com
authors.forename: Klaus-Martin
authors.initials: KM
authors.lastname: Kreusel
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Bechrakis
authors.forename: Juliane
authors.initials: J
authors.lastname: Riese
authors.forename: Lothar
authors.initials: L
authors.lastname: Krause
authors.forename: Joachim
authors.initials: J
authors.lastname: Wachtlin
authors.forename: Michael H
authors.initials: MH
authors.lastname: Foerster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002830:Choroid Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods*; D008545:Melanoma / Q000532:radiotherapy* / Q000628:therapy; D008875:Middle Aged; D011183:Postoperative Complications; D011680:Pupil; D011879:Radiotherapy Dosage; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D012429:Ruthenium Radioisotopes