Long-term outcomes of eye-conserving treatment with Ruthenium(106) brachytherapy for choroidal melanoma.
OBJECTIVE
To evaluate long-term outcomes of eye-conserving treatment using Ruthenium-106 plaque brachytherapy with or without transpupillary thermotherapy (TTT) for small to intermediate size choroidal melanomas.


METHODS
Outcomes of 425 consecutive patients were analysed. The median basal tumour diameter was 10.9 mm (range 4.8-15.9 mm), and the median apical height 4.2 mm (range 1.2-9.3 mm). Brachytherapy doses ranged from 400 to 600Gy with TTT (86%), or from 600 to 800Gy without TTT (14%), specified at the scleral surface. Kaplan-Meier survival curves, log-rank tests and Cox regression analysis were used for analysis.


RESULTS
Median follow-up was 50 months. Five-year actuarial local control was 96%. Five-year overall and metastases-free survival rates were 79.6% and 76.5%. Prognostic factors for metastasis-free survival were peripheral location (p=0.02) and smaller basal diameter (p<0.001). No dose effect relationships were found. Radiation side effects were frequent, with 2- and 5-year rates free of radiation complications of 60% and 35%. Five-year enucleation rate was 4.4% (10 for local recurrence, 7 for complications). Cosmetic and functional (visual acuity >0.10) eye preservation rates were 96% and 52% at 5 years.


CONCLUSIONS
Ruthenium-106 brachytherapy for choroidal melanoma provides excellent rates of local control and eye preservation.
Verschueren
Karijn M S
KM
Department of Radiation Oncology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.
Creutzberg
Carien L
CL
Schalij-Delfos
Nicoline E
NE
Ketelaars
Martijn
M
Klijsen
Floor L L
FL
Haeseker
Barbara I
BI
Ligtenberg
Sabine M B
SM
Keunen
Jan E E
JE
Marijnen
Corrie A M
CA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002830:Choroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D016896:Treatment Outcome
D012429:Ruthenium Radioisotopes