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Uveal Malignant Melanoma: Management Options for Brachytherapy

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Clinical Ophthalmic Oncology

Abstract

Moore first used brachytherapy for uveal melanoma in 1930 by inserting radon-222 seeds into the tumor [1]. This technique was later modified by Stallard and eventually further refined using radioactive plaques containing cobalt-60 anchored to the episcleral surface [2, 3]. In the United States, this radionuclide was gradually replaced by plaques loaded with iodine-125 seeds, as this provided less radiation to surrounding tissues [4, 5]. In Europe, the pioneering work of Lommatzsch in the 1970s led to the introduction of ruthenium-106 as a radioactive source for episcleral brachytherapy of uveal melanoma [6]. Although observational data suggested that there was no survival difference compared to patients enucleated for uveal melanoma, the Collaborative Ocular Melanoma Study (COMS) was launched in the mid-1980s and included a trial with patients with medium-sized uveal melanoma randomized to either enucleation or iodine brachytherapy [7, 8]. During the late 1980s and 1990s and in parallel with the COMS recruitment and trial period, episcleral brachytherapy evolved into one of the most commonly used techniques for treating patients with posterior uveal melanoma (Box 13.1).

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Authors and Affiliations

  1. Department of Vitreoretinal Diseases, St Eriks Eye Hospital, Karolinska Institutet, Polhemsgatan 50, Stockholm, SE-112 82, Sweden

    Stefan Seregard MD, PhD

  2. Ocular Oncology Service, Departments of Ophthalmology and Radiation Oncology, University of California, San Francisco, 10 Koret Way, K327, CA, 94143-0730, San Francisco, USA

    Bertil Damato MD, PhD, FRCOphth

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  1. Stefan Seregard MD, PhD
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  2. Bertil Damato MD, PhD, FRCOphth
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Correspondence to Stefan Seregard MD, PhD .

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Editors and Affiliations

  1. Ocular Oncology Service, Departments of Ophthalmology and Radiation Oncology, University of California, San Francisco, San Francisco, California, USA

    Bertil Damato

  2. Dept. of Ophthalmic Oncology, Cole Eye Institute Cleveland Clinic Foundation, Cleveland, Ohio, USA

    Arun D. Singh

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Seregard, S., Damato, B. (2014). Uveal Malignant Melanoma: Management Options for Brachytherapy. In: Damato, B., Singh, A. (eds) Clinical Ophthalmic Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54255-8_13

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