Clinical Experience with the Ruthenium‐ plaque Brachytherapy in Case of Choroidal Melanoma

Abstract

PurposeThe brachytherapy with β‐ emitting ruthenium‐ plaques is a well‐established treatment for patients with choroidal melanoma. This treatment modality has been used in our department since January 2011.MethodsA retrospective study of 104 eyes with choroidal melanoma that were treated with ruthenium‐ brachytherapy between January 2011 and December 2014. Patients were followed for regression and associated side‐ effects. The study included patients that had a follow‐ up time of at least 3 months.ResultsOf the 104 melanomas nine also showed an infiltration of the ciliary body, 32 manifested at a central location and 59 eyes showed an exudative retinal detachment prior to brachytherapy. The mean sclera contact dose was 519 Gy, the mean apical dose applied was 105 Gy. The mean apical depth of the melanoma prior to therapy was 4.3 mm and after 12 months 2.2 mm. In three cases a movement of the plaques was necessary since the plaque did not cover the tumour margins in total because of the diameter of the melanomas. In eight cases the tumour showed regrowth after an initial regression was noticed. All together four eyes had to be removed. In eight cases distant metastasis were detected and two eyes showed a radiation retinopathy.ConclusionsFor the treatment of choroidal melanoma the β‐ emitting ruthenium‐ plaques represent a therapy with a local tumour control rate of 92.3% and eye salvaging rate of 96.2%.