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Brachytherapy of Uveal Melanomas with Ruthenium-106 Plaques

  • Belaid, Asma (Radiation Oncology Department, Salah Azaiez Institute, Tunis-el Manar University) ;
  • Nasr, Chiraz (Radiation Oncology Department, Salah Azaiez Institute, Tunis-el Manar University) ;
  • Jmour, Omar (Radiation Oncology Department, Salah Azaiez Institute, Tunis-el Manar University) ;
  • Cherif, Aziz (Radiation Oncology Department, Salah Azaiez Institute, Tunis-el Manar University) ;
  • Kochbati, Lotfi (Radiation Oncology Department, Salah Azaiez Institute, Tunis-el Manar University) ;
  • Bouguila, Hedi (Ophtalmology Department, Hedi Raies, Faculty of Medicine of Tunis, Tunis-el Manar University) ;
  • Besbes, Mounir (Radiation Oncology Department, Salah Azaiez Institute, Tunis-el Manar University) ;
  • Benna, Farouk (Radiation Oncology Department, Salah Azaiez Institute, Tunis-el Manar University)
  • Published : 2016.12.01

Abstract

Background: Brachytherapy is the most commonly used conservative treatment for the uveal melanoma. The aim of this study was to evaluate therapeutic results of Ruthenium-106 plaque brachytherapy in the management of localized uveal melanoma cases. Methods: We reviewed retrospectively the clinical records of all patients treated in our department for an uveal melanoma, undergoing Ruthenium-106 plaque brachytherapy, from January 1996 to December 2015. We focused on clinical features, therapeutic characteristics, local and distant tumor control and side effects. Results: Nineteen patients were enrolled in our study. Mean age was 56.2 years (28-79) and the sex ratio was 1.37:1 males to females. Diagnosis was made on the basis of ophthalmological clinical examination, angiography, ultrasound and/or magnetic resonance. Median tumor diameter was 9.7 mm (6-13) and median thickness 4.4 mm (2.5-8). The dose of Ruthenium-106 plaque brachytherapy prescribed to the apex of each tumor was 70 Gy in all cases. The median radiation dose to the sclera surface was 226.4 Gy (range: 179.6-342.3) and the median total application time 115.2 hours (range: 27 to 237). After a median follow-up of 61.5 months, local control was achieved in 17 patients (89%): 16 demonstrated a partial tumor response and 1 tumor stabilization. Two patients suffered local progression leading to enucleation, one dying of hepatic metastasis. Radiation-induced complications were cataracts in 3 cases and vitreal hemorrhage in 2. Conclusion: Ruthenium-106 plaque brachytherapy is an efficient treatment for localized uveal melanoma, offering good local control with low toxicity.

Keywords

References

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