Visual acuity after Ruthenium{sup 106} brachytherapy of choroidal melanomas
- Ocular Oncology Service, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool (United Kingdom)
- Physics Department, Clatterbridge Centre for Oncology, Bebington, Wirral (United Kingdom)
- IC Statistical Services, Wirral (United Kingdom)
- Radiotherapy Department, Clatterbridge Centre for Oncology, Bebington, Wirral (United Kingdom)
Purpose: To report on conservation of visual acuity after Ruthenium{sup 106} (Ru-106) brachytherapy of choroidal melanoma. Methods and materials: This study was a noncomparative interventional case series of 458 patients with choroidal melanoma treated at a single center between January 1993 and December 2001. The intervention consisted of Ru-106 brachytherapy delivering minimum scleral and apex doses of 300 Gy and 80 Gy, respectively, using a 15-mm or 20-mm plaque. For discrete, posterior tumors, the plaque was positioned eccentrically with its posterior edge aligned with the posterior tumor margin. To ensure correct plaque positioning, any overlying extraocular muscles were dis-inserted, and the locations of both tumor and plaque edges were confirmed by transillumination and indentation. The main outcome measures were conservation of vision of 20/40 or better, 20/200 or better, and Counting Fingers or better, according to baseline variables. Results: The actuarial rate of conservation of 20/40 or better was 55% at 9 years, loss of such vision correlating with posterior tumor extension (p < 0.001), temporal tumor location (p = 0.001), increased tumor height (p = 0.01), and older age (p < 0.01) (Cox multivariate analysis). Similar analyses showed conservation of 20/200 or better in 57% of eyes at 9 years, loss correlating with reduced initial visual acuity (p < 0.001), posterior tumor extension (p < 0.001), and temporal tumor location (p = 0.006). Counting Fingers or better vision was conserved in 83% of patients at 9 years, loss correlating with increased tumor height (p < 0.0001). Local tumor recurrence occurred in 9 patients (actuarial rate, 3% at 9 years). Conclusion: Ruthenium{sup 106} brachytherapy of posterior choroidal melanoma achieves good conservation of vision if the tumor does not extend close to the optic nerve or fovea.
- OSTI ID:
- 20702147
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 63, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2005.02.059; PII: S0360-3016(05)00757-1; Copyright (c) 2005 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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