BRACHYTHERAPY (RU-106) FOR CHOROIDAL MELANOMA – OUR EXPERIENCE OF 14 YEARS

Abstract

Background. For many years, malignant melanoma of the choroid was treated with prompt enucleation. Recently several eye preserving methods have been developed. The aim of our study was to report on the therapeutic results in patients with primary choroidal melanoma treated with ruthenium-106 brachytherapy.Methods. A retrospective chart review of 65 patients treated with ruthenium-106 brachytherapy for choroidal melanoma from 1986 to 1997 was performed. The patients were 22 to 78 years old (mean 54.5 years). The height of the tumors was within the range of 1.5 to 7.1 mm (mean 4.7mm). The mean dose to the apex of the tumor was 100 Gy. Mean follow-up period was 90.6 months (range 22 to 169 months). Fundus photography, diagnostic ultrasound and best corrected visual acuity were performed during each examination before and after radiation.Results. 12 (18.4%) patients died from metastatic spread and 2 from other causes. Complete tumor regression occurred in 12 (18.4%) patients. Tumor regression was partial in 31 (47.7%) patients. Enucleation because of tumor growth was performed in 11 (16.9%) patients and in 2 for other reasons. 19 (30%) eyes retained visual acuity better than 0.5 and 49% of patients had visual acuity better than 0.1.Conclusions. Ruthenium brachytherapy has proved to be an effective conservative treatment for uveal melanomas thinner than 7mm. The present results correspond well with data in the literature. Visual outcome correlates with tumor location.

Keywords

• choroidal melanoma
• brachytherapy