Brachytherapy

Brachytherapy is the preferred radiation treatment modality for various intraocular tumors, most commonly, uveal melanoma. Radioactive sources are placed directly onto or around the tumor with the aid of episcleral plaques, whereby the employed sources exhibit an extremely sharp fall-off of dosage outside the few millimeters around the tumor. With such high focality, radiation dose to vision critical structures is minimized. Various sources have been used over the years, with iodine-125 being the most common. This chapter will highlight the history of brachytherapy for the treatment of intraocular tumors, current practice including isotopes and plaques utilized, as well as a comprehensive treatment planning and physics review.