title: Tumor control, eye preservation, and visual outcomes of ruthenium plaque brachytherapy for choroidal melanoma.
abstract: OBJECTIVE
  To evaluate outcomes in patients with posterior choroidal melanoma treated with ruthenium ((106)Ru) brachytherapy.
  
  
  METHODS
  A retrospective single institutional analysis of 83 of 94 consecutive patients who underwent (106)Ru brachytherapy was performed. Disease was mainly staged as small- and medium-sized nonmetastatic melanoma. The main parameters evaluated were tumor control (local control [LC] and progression-free survival [PFS]) and ocular preservation (enucleation-free survival [EFS]). Besides, functional evaluation was performed and complications were described.
  
  
  RESULTS
  The median follow-up was 39 (6-83) months. The median values of height and maximal basal diameter were 4.3 and 9.3mm, respectively. Median apical and basal doses were 100 and 307Gy, respectively. The actuarial 2-year LC, PFS, and EFS were 96.2%, 96.2%, and 95.5%, respectively. Actuarial 5-year LC, PFS, and EFS were 93.6%, 93.6%, and 84.1%, respectively. Preinsertion visual acuity (VA) maintenance was 34% (equal or better than before treatment). Approximately 56% of patients stayed with a minimum functional VA of 0.1 or more, from whom more than half stayed with 0.5 or more. Cataract was seen in 16% of treated eyes, and glaucoma was the rarest complication, with an incidence of 3%.
  
  
  CONCLUSIONS
  Small- and medium-sized choroidal melanomas can be adequately treated with (106)Ru brachytherapy, with high rates of tumor control and ocular preservation. Moreover, acceptable incidence of complications such as glaucoma and cataract are seen, and a reasonable part of patients stay with a minimum functional VA.
authors.affiliation: Department of Radiation Oncology, AC Camargo Hospital, São Paulo/SP, Brazil. dgmarconi@gmail.com
authors.forename: Daniel Grossi
authors.initials: DG
authors.lastname: Marconi
authors.forename: Douglas Guedes
authors.initials: DG
authors.lastname: de Castro
authors.forename: Lievin Matos
authors.initials: LM
authors.lastname: Rebouças
authors.forename: Gabriel Oliveira
authors.initials: GO
authors.lastname: Bernardes Gil
authors.forename: Ricardo Cesar
authors.initials: RC
authors.lastname: Fogaroli
authors.forename: Maria Aparecida
authors.initials: MA
authors.lastname: Conte Maia
authors.forename: Maria Leticia
authors.initials: ML
authors.lastname: Gobo Silva
authors.forename: Antonio Cassio
authors.initials: AC
authors.lastname: Assis Pellizzon
authors.forename: Maria Marta
authors.initials: MM
authors.lastname: Motono Chojniak
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D001938:Brazil / Q000453:epidemiology; D002830:Choroid Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D011379:Prognosis; D011832:Radiation Injuries / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D012429:Ruthenium Radioisotopes