Ruthenium-106 brachytherapy for iris and iridociliary melanomas

Br J Ophthalmol. 2018 Aug;102(8):1154-1159. doi: 10.1136/bjophthalmol-2017-310688. Epub 2017 Nov 9.

Abstract

Background and purpose: To evaluate ruthenium-106 (Ru106) brachytherapy as eye-conserving treatment of iris melanomas (IMs) and iridociliary melanomas (ICMs).

Materials and methods: Eighty-eight patients received Ru106 brachytherapy between 2006 and 2016. Primary outcome was local control, and secondary outcomes were metastasis, survival, eye preservation, complications and visual acuity (VA).

Results: Overall median follow-up was 36 months. Of 88 patients, 58 (65.9%) had IM and 30 (34.1%) had ICM. ICM were on average larger and more advanced than IM. Local failure-free survival at 3years was 98.9% (SE 1.2%). Metastasis-free survival was 98.2% (SE 1.8%) at 3years; no deaths due to melanoma occurred during follow-up. Eye preservation rate was 97.7%. Treatment-related toxicities were mostly mild and observed in 80.7% of the patients. Common toxicities were worsening of pre-existing or new cataract (51.1%), dry eyes (29.5%) and glaucoma (20.5%). VA was not affected by Ru106 brachytherapy, with only 2.3% having VA <0.33 (low vision) at follow-up.

Conclusions: Ru106 for IM and ICM yielded excellent local control (98.9%) and eye preservation (97.7%). Toxicities were common, but mostly mild and transient. Moreover, Ru106 did not affect visual acuity.

Keywords: ciliary body; iris; neoplasia; treatment other; vision.

MeSH terms

  • Adult
  • Aged
  • Brachytherapy / methods*
  • Ciliary Body / pathology
  • Ciliary Body / radiation effects*
  • Female
  • Follow-Up Studies
  • Humans
  • Iris Neoplasms / pathology
  • Iris Neoplasms / radiotherapy*
  • Male
  • Melanoma / pathology
  • Melanoma / radiotherapy*
  • Middle Aged
  • Radiotherapy Dosage
  • Ruthenium Radioisotopes / therapeutic use*
  • Treatment Outcome
  • Uveal Neoplasms / pathology
  • Uveal Neoplasms / radiotherapy*
  • Visual Acuity

Substances

  • Ruthenium Radioisotopes
  • Ruthenium-106