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Oncology
Local tumour control and patient survival after ruthenium-106 brachytherapy for small choroidal melanoma
  1. Beatrice Gallo1,
  2. Rohan Hussain1,
  3. Ranaa Al-Jamal1,2,
  4. Hagar Khalid3,4,
  5. Ian Stoker5,
  6. Gordon Hay1,6,7,
  7. Amit K Arora1,
  8. Peter W Szlosarek8,
  9. Mandeep S Sagoo1,4,8
  1. 1Ocular Oncology Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  2. 2Ocular Oncology Service, Helsinki University Central Hospital, Helsinki, Finland
  3. 3Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  4. 4Ophthalmology Department, Tanta University, Tanta, Egypt
  5. 5Department of Radiation Physics, Barts Health NHS Trust, London, UK
  6. 6Institute of Ophthalmology, University College London, London, UK
  7. 7NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and University College London Institute of Ophthalmology, London, UK
  8. 8Department of Medical Oncology, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Beatrice Gallo, Ocular Oncology Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK; beatricegallo.bg{at}gmail.com

Abstract

Aim To report local tumour control, metastasis and survival rates of patients with small choroidal melanoma (CM) after treatment with ruthenium-106 (Ru-106) plaque brachytherapy.

Methods Retrospective case series of 353 consecutive eyes with small CM (thickness ≤2.5 mm and largest basal diameter ≤16 mm) treated with Ru-106 brachytherapy at the London Ocular Oncology Service, between October 2004 and May 2019.

Results The final cohort included 310 eyes and tumour recurrence was observed in 52 (17%) eyes. Ocular retention rate was 96%. Metastatic disease and tumour-related death occurred in 18 (5.8%) and 12 (3.9%) patients, respectively. Metastases were diagnosed after a median of 54 (54±35; range 3.6–118) months from initial treatment. Kaplan-Meier estimates for tumour recurrence, melanoma-related metastases and survival were 17% (95% CI 13.3% to 22.9%), 4.8% (95% CI 2.6% to 8.5%) and 98% (95% CI 94.4% to 99.1%) at 5 years and 26% (95% CI 18.3% to 35.3%), 16% (95% CI 8.7% to 27.7%) and 92% (95% CI 84.5% to 95.7%) at 10 years, respectively. On multivariable analysis, factors predictive for tumour recurrence included juxtapapillary location, larger plaque and final tumour thickness, and for metastasis exudative retinal detachment.

Conclusion Small CMs treated with Ru-106 brachytherapy show recurrence and death rates of 17% and 2% at 5 years and 26% and 8% at 10 years. As small CMs have better prognosis than large tumours, early treatment is the key for better survival outcomes.

  • Choroid
  • Neoplasia
  • Prognosis
  • Risk Factors
  • Treatment Surgery

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

https://doi.org/10.1136/bjo-2023-324687

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

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    Footnotes

    • Contributors Study concept and design: BG and MSS. Acquisition, analysis, interpretation of data; drafting of the manuscript and critical revision for important intellectual content; final approval of the version to be published: all authors; study guarantors: BG and MSS.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.