title: A choice of radionuclide: Comparative outcomes and toxicity of ruthenium-106 and iodine-125 in the definitive treatment of uveal melanoma.
abstract: OBJECTIVE
  Both iodine-125 ((125)I) Collaborative Ocular Melanoma Study and ruthenium-106 ((106)Ru) eye plaques can achieve excellent tumor control in patients diagnosed with uveal melanoma. We analyzed our single institutional experience in the management of ocular melanoma treated with either (125)I or (106)Ru plaque brachytherapy.
  
  
  METHODS
  The records of 107 patients with uveal melanoma treated with either (106)Ru (n = 40) or (125)I (n = 67) plaque brachytherapy between 2000 and 2008 were retrospectively reviewed. Tumor control parameters and toxicity were assessed.
  
  
  RESULTS
  Actuarial 5-year rates of local control, progression-free survival, and overall survival with (106)Ru were 97%, 94%, and 92%, respectively. For (125)I, these values were 83%, 65%, and 80%. In the subset of patients with tumor apex height ≤5 mm (36 (125)I and 40 (106)Ru), there was no difference in overall survival; however, progression-free survival was significantly improved with (106)Ru (P = .02). Enucleation-free survival was significantly different between the 2 subsets, with no enucleations in the (106)Ru cohort (P = .02). Patients treated with (106)Ru experienced reduced retinopathy (P = .03) and cataracts (P < .01).
  
  
  CONCLUSIONS
  Both (125)I and (106)Ru eye plaque brachytherapy treatment result in encouraging tumor control for patients with uveal melanoma. We demonstrate that (106)Ru offers these benefits with reduced toxicity in patients treated for uveal melanomas ≤5 mm in apical height.
authors.affiliation: Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Vinita
authors.initials: V
authors.lastname: Takiar
authors.affiliation: Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: K Ranh
authors.initials: KR
authors.lastname: Voong
authors.affiliation: Department of Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Dan S
authors.initials: DS
authors.lastname: Gombos
authors.affiliation: Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, Delaware, and Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Firas
authors.initials: F
authors.lastname: Mourtada
authors.affiliation: Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Rechner
authors.affiliation: Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ann A
authors.initials: AA
authors.lastname: Lawyer
authors.affiliation: Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: William H
authors.initials: WH
authors.lastname: Morrison
authors.affiliation: Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
authors.affiliation: Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: bbeadle@mdanderson.org.
authors.forename: Beth M
authors.initials: BM
authors.lastname: Beadle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects* / Q000633:toxicity; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000009:adverse effects* / Q000633:toxicity; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000098943:Uveal Melanoma
chemical_list: D007457:Iodine Radioisotopes; D012429:Ruthenium Radioisotopes