Ruthenium plaque radiation therapy for iris and iridociliary melanomas.
OBJECTIVE
To determine the long-term effects of ruthenium-106 plaque radiation therapy for iris and iridociliary melanomas in terms of tumour regression and complications.


METHODS
Between 1 November 1997 and 31 December 2007, 36 patients with an iris or iridociliary melanoma were treated with Ruthenium-106 (Ru-106) ophthalmic plaque radiation therapy. The median follow-up was 6.5 years with a range of 2-11 years. The mean tumour apex dose was 151.5 Gy. Main outcome measures were local tumour control and radiation-related ocular complications.


RESULTS
The mean age of the patients at the time of treatment was 54 years (range 14-82). The tumours had a median largest basal dimension of 4.8 mm (range 3-11) and a prominence of 2.3 mm (range 0.8-5), with a median involvement of three clock hours (range 1-6). The tumours were confined to the iris in 14 patients (39%), extended into the anterior ciliary body in 12 (33%), while the anterior ciliary body tumour extended into the iris in ten patients (28%). Tumours regressed in all patients (100%) with a mean regression of 80% of the original tumour size at 7 years of follow-up. Radiation-related complications included corneal erosions on the first postoperative day in nine patients (25%), cataract in four of 11 patients free of cataract before treatment (36%) and postradiation glaucoma in one patient (3%). Visual acuity of 20/200 or worse was present in one of 20 patients (5%) at 6 years of follow-up. Local recurrences occurred in two patients (5%), 2 and 5 years after the radiation therapy respectively, and both underwent enucleation. Distant metastases occurred in one of these enucleated patients (3%) 2 years after treatment.


CONCLUSIONS
Ru-106 plaque radiation therapy for iris and iridociliary melanoma resulted in good local tumour control and preservation of visual acuity with few and treatable side-effects.
Razzaq
Lubna
L
Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands.
Keunen
Jan E E
JE
Schalij-Delfos
Nicoline E
NE
Creutzberg
Carien L
CL
Ketelaars
Martijn
M
de Keizer
Rob J W
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002924:Ciliary Body / Q000473:pathology / Q000528:radiation effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015811:Iris Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012429:Ruthenium Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D014792:Visual Acuity; D055815:Young Adult
D012429:Ruthenium Radioisotopes