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Ruthenium-106 plaque brachytherapy for uveal melanoma.

Lisa Tarmann1, Werner Wackernagel1, Alexander Avian2

  • 1Department of Ophthalmology, Medical University Graz, Graz, Austria.

The British Journal of Ophthalmology
|May 17, 2015
PubMed
Summary

Ruthenium-106 brachytherapy effectively controls uveal melanoma, preserves the eye, and maintains visual function. However, adjunct sandwich therapy negatively impacts visual outcomes, highlighting the need for careful treatment planning.

Keywords:
ChoroidNeoplasiaTreatment other

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Area of Science:

  • Ophthalmology
  • Radiation Oncology
  • Oncology

Background:

  • Uveal melanoma is a rare intraocular malignancy.
  • Ruthenium-106 brachytherapy is a localized radiation treatment option.

Purpose of the Study:

  • To evaluate the efficacy of Ruthenium-106 brachytherapy for uveal melanoma.
  • To assess local tumor control, eye preservation, and visual outcomes.
  • To identify risk factors influencing treatment success.

Main Methods:

  • Retrospective analysis of 143 eyes with uveal melanoma treated between 1997-2012.
  • Ruthenium-106 brachytherapy was the primary treatment modality.
  • Time-to-event analysis and competing risk regression were used to analyze outcomes.

Main Results:

  • Local tumor recurrence rates at 12, 24, and 48 months were 3%, 8.4%, and 14.7%, respectively.
  • Eye preservation rates at 12, 24, and 48 months were 97.7%, 94.7%, and 91.8%.
  • Significant risk factors for recurrence included age and initial visual acuity; for enucleation, they included initial visual acuity, tumor height, and tumor category. Adjunct transpupillary thermotherapy (TTT) showed worse visual outcomes.

Conclusions:

  • Ruthenium-106 brachytherapy is effective for uveal melanoma treatment, offering good tumor control and eye preservation.
  • Visual outcomes are generally favorable, but adjunct sandwich therapy is associated with poorer visual function.
  • Patient age, initial visual acuity, tumor height, and tumor category are critical factors influencing treatment outcomes.