Combined brachytherapy and transpupillary thermotherapy for large choroidal melanoma: tumor regression and early complications.
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.
Kreusel
Klaus-Martin
KM
Augen-Zentrum, DRK-Kliniken Westend, Spandauer Damm 130, 14050 Berlin, Germany. KMKreusel@aol.com
Bechrakis
Nikolaos
N
Riese
Juliane
J
Krause
Lothar
L
Wachtlin
Joachim
J
Foerster
Michael H
MH
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
D012429:Ruthenium Radioisotopes