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Combined brachytherapy and transpupillary thermotherapy for large choroidal melanoma: tumor regression and early complications

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Abstract

Background

To determine the effectiveness and risk profile of combined ruthenium- (Ru)-106-brachytherapy and transpupillary thermotherapy (TTT) of the tumour apex for the treatment of large choroidal melanoma.

Methods

A consecutive series of 31 large choroidal melanoma treated by Ru-106-brachytherapy and adjuvant TTT was studied. TTT was performed 1 day prior to plaque removal and up to 3 times (mean: 1.8) during follow-up. Evaluation comprised tumour regression, treatment-related adverse events, necessity of additional treatment and visual results.

Results

Mean follow-up was 21.6±7.8 (10.8–38.3) months. Mean tumour thickness was 6.8±1.0 (5.0–8.9) mm prior to treatment. Mean residual tumour thickness at the end of follow-up was 2.5±1.0 mm. Relevant adverse treatment effects were exudative maculopathy or macula oedema (22.6%), vitreous haemorrhage (16.1%), optic neuropathy (16.1%) and retinal detachment (9.7%). One tumour recurrence occurred during follow-up, and was treated by enucleation.

Conclusions

The combination of Ru-106-brachytherapy with TTT allows for the treatment of large posterior choroidal melanoma. The rate of treatment-related adverse events appears to be acceptable.

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Authors and Affiliations

  1. Augen-Zentrum, DRK-Kliniken Westend, Spandauer Damm 130, 14050, Berlin, Germany

    Klaus-Martin Kreusel

  2. Universitätsaugenklinik und Poliklinik, Charité - Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany

    Nikolaos Bechrakis, Juliane Riese, Lothar Krause, Joachim Wachtlin & Michael H. Foerster

Authors
  1. Klaus-Martin Kreusel
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  2. Nikolaos Bechrakis
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  3. Juliane Riese
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  4. Lothar Krause
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  5. Joachim Wachtlin
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  6. Michael H. Foerster
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Correspondence to Klaus-Martin Kreusel.

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Kreusel, KM., Bechrakis, N., Riese, J. et al. Combined brachytherapy and transpupillary thermotherapy for large choroidal melanoma: tumor regression and early complications. Graefe's Arch Clin Exp Ophthalmol 244, 1575–1580 (2006). https://doi.org/10.1007/s00417-006-0357-8

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  • DOI: https://doi.org/10.1007/s00417-006-0357-8

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