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Eccentric ruthenium plaque radiotherapy of posterior choroidal melanoma

  • Oncology
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Abstract

Background

The aim of this work is to report on conservation of visual acuity after eccentric ruthenium106 (Ru-106) brachytherapy of posterior choroidal melanoma.

Methods

Fifty-four patients with choroidal melanoma extending to within 5 mm of the optic disc or fovea were treated at a single institution during the 3 years up to July 31, 2007. The plaque was positioned eccentrically with its posterior edge aligned with the posterior tumor margin to reduce the radiation dose to the optic disc and fovea. The main outcome measures were local tumor control and conservation of vision of 6/12 or better, according to baseline variables.

Results

The tumors had a mean longest basal diameter of 12.0 mm and a mean thickness of 3.1 mm. The posterior tumor margin extended to within 3 mm of the fovea in 30 patients (56%). In the 24 eyes with the posterior tumor margin located 3.1–5.0 mm from the fovea, 74.9% retained visual acuity of 6/12 or better 4 years after treatment (95% confidence interval [CI], 55.5–94.3%). In the 30 eyes with tumor extension to within 3.0 mm of the fovea, then 3 years after treatment only 25.3% retained such vision (95% CI, 5.3–45.3%). Recurrence at the posterior tumor margin occurred in two patients.

Conclusions

Eccentric ruthenium106 plaque radiotherapy of posterior choroidal melanoma achieves good rates of local tumor control and conservation of vision if special measures are taken to ensure that the plaque is positioned correctly.

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References

  1. Lommatzsch PK, Vollmar R (1966) Einneuer Weg zur konservatinen Therapie intraokularer Tumoren mit Betastrahlen (Ru-106/Rh-106) unter Erhaltung der Sehfahigkeit. Klin Monatsbl Augenheilkd 148:682–699

    PubMed  CAS  Google Scholar 

  2. Jampol LM, Moy CS, Murray TG, Reynolds SM, Albert DM, Schachat AP, Diddie KR, Engstrom RE Jr, Finger PT, Hovland KR, Joffe L, Olsen KR, Wells CG (2002) The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: IV. Local treatment failure and enucleation in the first 5 years after brachytherapy. COMS report no. 19. Ophthalmology 109:2197–2206

    Article  PubMed  Google Scholar 

  3. Nag S, Quivey JM, Earle JD, Followill D, Fontanesi J, Finger PT (2003) The American Brachytherapy Society recommendations for brachytherapy of uveal melanomas. Int J Radiat Oncol Biol Phys 56:544–555

    Article  PubMed  Google Scholar 

  4. Damato B, Patel I, Campbell IR, Mayles HM, Errington RD (2005) Local tumor control after 106Ru brachytherapy of choroidal melanoma. Int J Radiat Oncol Biol Phys 63(2):385–391, 1

    Article  PubMed  Google Scholar 

  5. Damato B, Patel I, Campbell IR, Mayles HM, Errington RD (2005) Visual acuity after Ruthenium(106) brachytherapy of choroidal melanomas. Int J Radiat Oncol Biol Phys 63(2):392–400, 1

    Article  PubMed  Google Scholar 

  6. Damato B, Groenewald CP, McGalliard JN, Wong D (2002) Rhegmatogenous retinal detachment after transscleral local resection of choroidal melanoma. Ophthalmology 109:2137–2143

    Article  PubMed  Google Scholar 

  7. Finger PT (1997) Radiation therapy for choroidal melanoma (therapeutic review). Surv Ophthalmol 42:215–232

    Article  PubMed  CAS  Google Scholar 

  8. Fontanesi J, Nag S (1997) Brachytherapy for ocular disease. In: Nag S (ed) Principles and practice of brachytherapy. Future Publishing Company Inc, Armonk, NY, pp 291–304. doi:291

    Google Scholar 

  9. Fontanesi J, Meyer D, Xu S, Tai D (1993) Treatment of choroidal melanoma with I-125 plaque. Int J Radiat Oncol Biol Phys 26:619–623

    Article  PubMed  CAS  Google Scholar 

  10. Searly R, Buret E, Clemingshaw H, Stannard C, Hering E, Shackleton D, Korrubel J, le Roux PL, Sevel D, van Oldenborgh M, van Selm J (1980) Progress in the use of iodine therapy for tumors of the eye. Br J Radiol 53:1052–1060

    Article  Google Scholar 

  11. Garretson BR, Robertson DM, Earle JD (1987) Choroidal melanoma treatment with 125I brachytherapy. Arch Ophthalmol 105:1394–1397

    Article  PubMed  CAS  Google Scholar 

  12. Lommatzsch PK (1986) Results after beta-irradiation(106Ru/106Rh) of choroidal melanomas: 20 years’ experience. Br J Ophthalmol 70:844–851

    Article  PubMed  CAS  Google Scholar 

  13. De Potter PD, Shields CL, Shields JA, Cater JR, Brady LW (1996) Plaque radiotherapy for juxtapapillary choroidal melanoma. Visual acuity and survival outcome. Arch Ophthalmol 114:1357–1365

    Article  PubMed  Google Scholar 

  14. Stannard C, Sealy R, Shackelton D, Hill J, Korrubel J (1987) The use of iodine-125 plaques in the treatment of retinoblastoma. Ophthalmic Paediatr Genet 8(2):89–93

    Article  PubMed  CAS  Google Scholar 

  15. Mameghan H, Karolis C, Fisher R, Mameghan J, Billson FA, Donaldson EJ, Giblin ME, Hunyor AB (1992) Iodine-125 irradiation of choroidal melanoma: clinical experience from the Prince of Wales and Sydney Eye Hospitals. Australas Radiol 36(3):249–252

    Article  PubMed  CAS  Google Scholar 

  16. Kreissig I, Rose D, Jost B (1993) Long-term follow-up of iodine-125 brachytherapy for choroidal melanomas. Part I: Anatomical results and life expectancy. Eur J Ophthalmol 3:121–126

    PubMed  CAS  Google Scholar 

  17. Giblin M (1988) Iodine-125 plaque radiation therapy for choroidal melanoma. In: Proceedings of the Annual Scientific Meeting of the Royal Australian College of Ophthalmology

  18. Robertson DM, Fountain KS, Anderson JA, Posthumus GW (1981) Radioactive iodine-125 as a therapeutic radiation source for management of intraocular tumors. Trans Am Ophthalmol Soc 79:294–306

    PubMed  CAS  Google Scholar 

  19. Diener-West M, Earle JD, Fine SL, Hawkins BS, Moy CS, Reynolds SM, Schachat AP, Straatsma BR (2001) The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma, III: initial mortality findings. COMS Report No. 18. Arch Ophthalmol 119(7):969–982

    PubMed  CAS  Google Scholar 

  20. Finger PT, Berson A, Ng T, Szechter A (2002) Palladium-103 plaque radiotherapy for choroidal melanoma: an 11-year study. Int J Radiat Oncol Biol Phys 54(5):1438–1445, 1

    Article  PubMed  Google Scholar 

  21. Robertson DM, Earle J, Anderson JA (1983) Preliminary observations regarding the use of iodine-125 in the management of choroidal melanoma. Trans Ophthalmol Soc UK 103(Pt 2):155–160

    PubMed  Google Scholar 

  22. Packer S, Rotman M (1980) Radiotherapy of choroidal melanoma with iodine-125. Int Ophthalmol Clin 20:135–142

    PubMed  CAS  Google Scholar 

  23. Packer S, Stoller S, Lesser ML, Mandel FS, Finger PT (1992) Long-term results of iodine 125 irradiation of uveal melanoma. Ophthalmology 99(5):767–773, discussion 774

    PubMed  CAS  Google Scholar 

  24. Lommatzsch PK, Werschnik C, Schuster E (2000) Long-term follow-up of Ru-106/Rh-106 brachytherapy for posterior uveal melanoma. Graefes Arch Clin Exp Ophthalmol 238(2):129–137

    Article  PubMed  CAS  Google Scholar 

  25. Lommatzsch PK, Lommatzsch R (1991) Treatment of juxtapapillary melanomas. Br J Ophthalmol 75(12):715–717

    Article  PubMed  CAS  Google Scholar 

  26. Finger PT, Buffa A, Mishra S, Berson A, Bosworth JL, Vikram B (1994) Palladium 103 plaque radiotherapy for uveal melanoma. Clinical experience. Ophthalmology 101(2):256–263

    PubMed  CAS  Google Scholar 

  27. Finger PT, Berson A, Szechter A (1999) Palladium-103 plaque radiotherapy for choroidal melanoma: results of a 7-year study. Ophthalmology 106(3):606–613

    Article  PubMed  CAS  Google Scholar 

  28. Lommatzsch PK, Alberti W, Lommatzsch R, Rohrwacher F (1994) Radiation effects on the optic nerve observed after brachytherapy of choroidal melanomas with 106Ru/106Rh plaques. Graefes Arch Clin Exp Ophthalmol 232:482–487

    Article  PubMed  CAS  Google Scholar 

  29. Gunduz K, Shields CL, Shields JA, Cater J, Freire JE, Brady LW (1999) Radiation complications and tumor control after plaque radiotherapy of choroidal melanoma with macular involvement. Am J Ophthalmol 127:579–589

    Article  PubMed  CAS  Google Scholar 

  30. Gragoudas ES, Li W, Lane AM, Munzenrider J, Egan KM (1999) Risk factors for radiation maculopathy and papillopathy after intraocular irradiation. Ophthalmology 106:1571–1577

    Article  PubMed  CAS  Google Scholar 

  31. Shields CL, Shields JA, Cater J, Gündüz K, Miyamoto C, Micaily B, Brady LW (2000) Plaque radiotherapy for uveal melanoma: long-term visual outcome in 1106 consecutive patients. Arch Ophthalmol 118(9):1219–1228

    Article  PubMed  CAS  Google Scholar 

  32. Bergman L, Nilsson B, Lundell G, Lundell M, Seregard S (2005) Ruthenium brachytherapy for uveal melanoma, 1979-2003: survival and functional outcomes in the Swedish population. Ophthalmology 112(5):834–840

    Article  PubMed  Google Scholar 

  33. Summanen P, Immonen I, Kivelä T, Tommila P, Heikkonen J, Tarkkanen A (1995) Visual outcome of eyes with malignant melanoma of the uvea after ruthenium plaque radiotherapy. Ophthalmic Surg Lasers 26(5):449–460

    PubMed  CAS  Google Scholar 

  34. Papageorgiou KI, Cohen VM, Bunce C, Kinsella M, Hungerford JL (2011) Predicting local control of choroidal melanomas following 106Ru plaque brachytherapy. Br J Ophthalmol 95(2):166–170

    Article  PubMed  CAS  Google Scholar 

  35. Harbour JW, Murray TG, Byrne SF, Hughes JR, Gendron EK, Ehlies FJ, Markoe AM (1996) Intraoperative echographic localization of iodine 125 episcleral radioactive plaques for posterior uveal melanoma. Retina 16(2):129–134

    Article  PubMed  CAS  Google Scholar 

  36. Finger PT, Romero JM, Rosen RB, Iezzi R, Emery R, Berson A (1998) Three-dimensional Ultrasonography of Choroidal Melanoma. Localization of Radioactive Eye Plaques. Arch Ophthalmol 116:305–312

    PubMed  CAS  Google Scholar 

  37. Tabandeh H, Chaudhry NA, Murray TG, Ehlies F, Hughes R, Scott IU, Markoe AM (2000) Intraoperative echographic localization of iodine-125 episcleral plaque for brachytherapy of choroidal melanoma. Am J Ophthalmol 129(2):199–204

    Article  PubMed  CAS  Google Scholar 

  38. Summanen P, Immonen I, Kivelä T, Tommila P, Heikkonen J, Tarkkanen A (1996) Radiation related complications after ruthenium plaque radiotherapy of uveal melanoma. Br J Ophthalmol 80:732–739

    Article  PubMed  CAS  Google Scholar 

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None of the authors has any financial/conflicting interest or funding source to disclose.

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Correspondence to Andrea Russo.

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The authors have full control of all primary data and agree to allow Graefe’s Archive for Clinical and Experimental Ophthalmology to review data if requested.

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Russo, A., Laguardia, M. & Damato, B. Eccentric ruthenium plaque radiotherapy of posterior choroidal melanoma. Graefes Arch Clin Exp Ophthalmol 250, 1533–1540 (2012). https://doi.org/10.1007/s00417-012-1962-3

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  • DOI: https://doi.org/10.1007/s00417-012-1962-3

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