Results after beta-irradiation (106Ru/106Rh) of choroidal melanomas: 20 years' experience

From 1964 to 1984 309 patients with choroidal melanoma were treated with 106Ru/106Rh beta ray applicators (1000 Gy at the apex of the tumour within 7-14 days). In cases 216 (69.9%) this treatment was successful for a mean follow-up period of 6.7 years after irradiation. In 53 cases (17.2%) the eye had to be enucleated, and 40 patients (12.9%) died from metastases within this period. Of the 216 successfully treated patients 114 (52.8%) developed flat scars and 49 (22.7%) retained a visual acuity of 1.5-0.5. Radiogenic late complications with damage to the retinal capillary system were the main causes of visual deterioration, especially in eyes with tumours close to the posterior pole. The survival rate is substantially higher than that for patients whose eyes were primarily enucleated. beta Ray applicators with 106Ru/106Rh can be recommended as an effective tool and a simple and cheap procedure to cure patients with small and medium sized choroidal melanomas. They save the eye without endangering our patients' lives.