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Clinical science
Use of Ruthenium-106 Brachytherapy for Iris Melanoma: The Scottish Experience
  1. Umiya Agraval1,
  2. Manvi Sobti1,
  3. Heather C Russell1,
  4. David Lockington1,
  5. Diana Ritchie2,
  6. Paul Cauchi1,
  7. Ewan G Kemp1,
  8. Vikas Chadha1
  1. 1 Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK
  2. 2 Oncology, Beatson West of Scotland Cancer Center, Glasgow, UK
  1. Correspondence to Dr Umiya Agraval, Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK; umiya.agraval{at}nhs.net

Abstract

Purpose To analyse long-term outcomes of ruthenium-106 (106Ru) plaque brachytherapy for the treatment of iris melanoma.

Methods We retrospectively reviewed medical records of 19 consecutive patients with pure iris melanoma treated with 106Ru plaque brachytherapy between 1998 and 2016 at the Scottish Ophthalmic Oncology Service, Glasgow. The iris melanoma was treated with a ruthenium plaque placed on the corneal surface to deliver a surface dose of 555 Gy. We analysed vision preservation, local tumour control, radiation-related complications, eye retention rates, symptomatic metastasis and melanoma-related mortality.

Results The mean largest basal diameter of the lesions was 3.50±1.42 mm (range 1.6–6.5 mm), and the mean maximum height was 1.47±0.65 mm (range 0.7–2.8 mm). The tumour control and eye retention were 100% at a mean follow-up of 62 months (range 6–195 months). A 62% reduction in tumour height was observed on ultrasonography. Complications included cataract (68%), dry eye (47%), uveitis (37%) and scleral thinning (5%). At the final follow-up visit, the mean loss of Snellen visual acuity was 1.11±2.90 lines and vision of 6/9 or better was maintained in 53% of patients. None of the patients had evidence of symptomatic metastasis (non-imaged) or melanoma-related mortality.

Conclusions 106Ru plaque treatment for iris melanoma was highly effective a high tumour control, no tumour recurrences and a relatively a low complication rate.

  • Melanoma
  • Brachytherapy
  • Ruthenium
  • Uveal neoplasms

https://doi.org/10.1136/bjophthalmol-2017-310278

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    Footnotes

    • Contributors Substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data: VC, UA, MS, DL, HCR, DR, EGK and PC. Drafting the work or revising it critically for important intellectual content: UA, MS, VC and PC. Final approval of the version published: UA, VC. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: agreed by all authors. Acknowledgement to Susan Ewan, onology co-ordinator, for facilitating this study.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Provenance and peer review Not commissioned; externally peer reviewed.