Long-term outcomes of eye-conserving treatment with Ruthenium(106) brachytherapy for choroidal melanoma

Author(s):
Verschueren, K.M.S.; Creutzberg, C.L. (0000-0002-7008-4321); Schalij-Delfos, N.E.; Ketelaars, M.; Klijsen, F.L.L.; Haeseker, B.I.; Ligtenberg, S.M.B.; Keunen, J.E.E.; Marijnen, C.A.M. (0000-0003-0189-5953)
Published
2010
Publication type
Article / Letter to editor

Abstract

Purpose: To evaluate long-term outcomes of eye-conserving treatment using Ruthenium-106 plaque brachytherapy with or without transpupillary thermotherapy (TTT) for small to intermediate size choroidal melanomas. Methods: Outcomes of 425 consecutive patients were analysed. The median basal tumour diameter was 10.9 mm (range 4.8-15.9 mm), and the median apical height 4.2 mm (range 1.2-9.3 mm). Brachytherapy doses ranged from 400 to 600 Gy with TIT (86%), or from 600 to 800 Gy without TTT (14%), specified at the scleral surface. Kaplan-Meier survival curves, log-rank tests and Cox regression analysis were used for analysis. Results: Median follow-up was 50 months. Five-year actuarial local control was 96%. Five-year overall and metastases-free survival rates were 79.6% and 76.5%. Prognostic factors for metastasis-free survival were peripheral location (p = 0.02) and smaller basal diameter (p < 0.001). No dose effect relationships were found. Radiation side effects were frequent, with 2- and 5-year rates free of radiation complications of 60% and 35%. Five-year enucleation rate was 4.4% (10 for local recurrence, 7 for complications). Cosmetic and functional (visual acuity >0.10) eye preservation rates were 96% and 52% at 5 years. Conclusions: Ruthenium-106 brachytherapy for choroidal melanoma provides excellent rates of local control and eye preservation. (C) 2010 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 95 (2010) 332-338

Choroidal melanoma Eye-conserving treatment Brachytherapy Ruthenium-106 plaque brachytherapy Prognostic factors posterior uveal melanoma combined plaque radiotherapy coms randomized trial local tumor-control visual-acuity transpupillary thermotherapy stereotactic radiotherapy consecutive patients ocular melanoma follow-up
Date issued
2010-06-30
Language
English
Is part of
Radiotherapy and Oncology (2010), Vol. 95, no. 3, p. 332-338
hdl
1887/109786
doi
10.1016/j.radonc.2010.03.023