title: The comparison of ruthenium brachytherapy and simultaneous transpupillary thermotherapy of choroidal melanoma with brachytherapy alone.
abstract: OBJECTIVE
  To compare the outcomes of combined treatment of choroidal melanoma with ruthenium brachytherapy (BT) simultaneously with transpupillary thermotherapy (TTT) and treatment with BT alone.
  
  
  METHODS
  Two matched groups of patients, one treated with BT and simultaneous TTT (Group BT+TTT, n=63), the other treated with BT alone (Group BT, n=70) were analyzed retrospectively. The main outcome measures were rate of tumor regression, recurrences, enucleations, metastases, recurrence-free and overall survival rate, and visual acuity, assessed by Kaplan-Meier analysis.
  
  
  RESULTS
  Patients were matched according to mean age (p=0.22), mean tumor thickness (6.4 vs. 6.25mm, range 2.5-10.8mm, p=0.59), and mean length of followup (42 vs. 34.4 months, range 3-109, p=0.052). Tumor largest basal diameter (13.0 vs. 12.9mm), tumor location, and mean radiation dose (apical 135 vs. 136Gy and scleral 1294 vs. 1438Gy) were also similar in both groups (p>0.1). Treatment with BT+TTT resulted in higher rate of tumor regression (63% vs. 49%, respectively, p=0.036), lower 5-year tumor recurrence rate (96% vs. 83%, p<0.034), and higher eye-globe preservation (98% vs. 87%, p<0.024) and recurrence-free survival rates (89% vs. 67%, p<0.017) than treatment with BT alone. There was no difference in complications (p>0.5), metastasis-free (93% vs. 81%, p>0.22) and overall survival rates (91% vs. 81%, p>0.39), or in visual outcomes.
  
  
  CONCLUSIONS
  Combined treatment of choroidal melanoma with ruthenium BT and simultaneous TTT seems to provide higher local control, eye-globe preservation, and recurrence-free survival rates than treatment with BT alone and results in similar rates of metastases and overall survival.
authors: Ocular Oncology Department, The S. Fyodorov Eye Microsurgery Complex, Moscow, Russia. yarovoyaa@yandex.ru
authors: Andrey A
authors: AA
authors: Yarovoy
authors: Dzhavid A
authors: DA
authors: Magaramov
authors: Evgeniya S
authors: ES
authors: Bulgakova
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D002830:Choroid Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008297:Male; D008545:Melanoma / Q000532:radiotherapy / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D016019:Survival Analysis; D014792:Visual Acuity
chemical_list: D012429:Ruthenium Radioisotopes