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Clinical science
Ruthenium-106 brachytherapy for iris and iridociliary melanomas
  1. Marina Marinkovic1,
  2. Nanda Horeweg2,
  3. Mirjam S Laman2,
  4. Jaco C Bleeker1,
  5. Martijn Ketelaars2,
  6. Femke P Peters2,
  7. Gre P M Luyten1,
  8. Carien L Creutzberg2
  1. 1 Department of Ophthalmology and Melanoma Center, Leiden University Medical Center, Leiden, The Netherlands
  2. 2 Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr Marina Marinkovic, Department of Ophthalmology and Melanoma Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; m.marinkovic{at}lumc.nl

Abstract

Background and purpose To evaluate ruthenium-106 (Ru106) brachytherapy as eye-conserving treatment of iris melanomas (IMs) and iridociliary melanomas (ICMs).

Materials and methods Eighty-eight patients received Ru106 brachytherapy between 2006 and 2016. Primary outcome was local control, and secondary outcomes were metastasis, survival, eye preservation, complications and visual acuity (VA).

Results Overall median follow-up was 36 months. Of 88 patients, 58 (65.9%) had IM and 30 (34.1%) had ICM. ICM were on average larger and more advanced than IM. Local failure-free survival at 3years was 98.9% (SE 1.2%). Metastasis-free survival was 98.2% (SE 1.8%) at 3years; no deaths due to melanoma occurred during follow-up. Eye preservation rate was 97.7%. Treatment-related toxicities were mostly mild and observed in 80.7% of the patients. Common toxicities were worsening of pre-existing or new cataract (51.1%), dry eyes (29.5%) and glaucoma (20.5%). VA was not affected by Ru106 brachytherapy, with only 2.3% having VA <0.33 (low vision) at follow-up.

Conclusions Ru106 for IM and ICM yielded excellent local control (98.9%) and eye preservation (97.7%). Toxicities were common, but mostly mild and transient. Moreover, Ru106 did not affect visual acuity.

  • iris
  • ciliary body
  • neoplasia
  • treatment other
  • vision

https://doi.org/10.1136/bjophthalmol-2017-310688

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    Footnotes

    • Contributors MM, NH and CLC had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. MM contributed to the conception and design of the study; the data acquisition, analysis and interpretation; and drafting and final approval of the manuscript. NH contributed to the conception and design of the study; data collection, analysis and interpretation; and drafting and final approval of the manuscript. MSL contributed to the data acquisition, and critical revision and final approval of the manuscript. JCB contributed to the data acquisition, and critical revision and final approval of the manuscript. MK contributed to the data acquisition, and critical revision and final approval of the manuscript. FPP contributed to the data acquisition, and critical revision and final approval of the manuscript. GPML contributed to the conception and design of the study, data acquisition, and critical revision and final approval of the manuscript. CLC contributed to the conception and design of the study, management, and critical revision and final approval of the manuscript.

    • Competing interests None declared.

    • Patient consent Not obtained.

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

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