Results of contact beta-irradiation of choroidal melanomas

Between the end of 1986 and the end of October 1996 81 patients suffering from choroidal melanoma were irradiated at the Department of Ophthalmology University Medical School of Debrecen. The irradiations were performed with Ruthenium-106 beta ray emitting scleral plaques (ophthalmic applicators). The radioactive plaques were implanted surgically, fixed by episcleral sutures onto the sclera covering the base of the tumour, and removed by another operation when sufficient time for irradiation had elapsed. For the treatment of tumours in the vicinity of the optic nerve special plaques were used with a notch for the nerve. Precise localisation of the tumours was established by intraoperative ultrasonography and transillumination. The mean follow up period was 3.5 years after the irradiation. Tumour regression was recorded by fluorescein angiography, ultrasonography and fundus photography. In 75 cases (92.5%) the treatment was successful. Additional laser photocoagulation was performed after irradiation in 26 cases. The irradiation by Ruthenium-106 scleral plaques of choroidal melanomas proved to be an effective treatment in cases of small and medium sized choroidal melanomas in our practice and the results are similar to those of the largest radiotherapy centers of Europe.