Combined brachytherapy and transpupillary thermotherapy for large choroidal melanoma: tumor regression and early complications
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To determine the effectiveness and risk profile of combined ruthenium- (Ru)-106-brachytherapy and transpupillary thermotherapy (TTT) of the tumour apex for the treatment of large choroidal melanoma.
A consecutive series of 31 large choroidal melanoma treated by Ru-106-brachytherapy and adjuvant TTT was studied. TTT was performed 1 day prior to plaque removal and up to 3 times (mean: 1.8) during follow-up. Evaluation comprised tumour regression, treatment-related adverse events, necessity of additional treatment and visual results.
Mean follow-up was 21.6±7.8 (10.8–38.3) months. Mean tumour thickness was 6.8±1.0 (5.0–8.9) mm prior to treatment. Mean residual tumour thickness at the end of follow-up was 2.5±1.0 mm. Relevant adverse treatment effects were exudative maculopathy or macula oedema (22.6%), vitreous haemorrhage (16.1%), optic neuropathy (16.1%) and retinal detachment (9.7%). One tumour recurrence occurred during follow-up, and was treated by enucleation.
The combination of Ru-106-brachytherapy with TTT allows for the treatment of large posterior choroidal melanoma. The rate of treatment-related adverse events appears to be acceptable.
KeywordsChoroidal melanoma Transpupillary thermotherapy Brachytherapy