High-dose 106Ruthenium plaque brachytherapy for posterior uveal melanoma.: A clinico-pathologic study

Background. The purpose of this study was to report the multifactorial results of high-dose (106)Ruthenium plaque brachytherapy for (cilio-) choroidal melanoma and to confirm them by histological examinations. Patients and methods. 100 patients with choroidal or ciliochoroidal melanoma treated by high-dose (106)Ruthenium plaque brachytherapy were followed-up for 5 years. 12 secondary enucleated eyes were compared to a non-irradiated matched group by light microscopy. Results. The 5-year local tumour control rate was 93%, the 5-year survival rate 91%. Late radiogenic side effects occured as a retinopathy in 13%, as an optic neuropathy in 5% and as a secondary glaucoma in 3% of the patients. 14% had to be enucleated, 10% developed metastases. The histopathologic examination revealed significantly higher degrees of necrosis (p= 0,041), balloon cell degeneration ( p= 0,025) and fibrosis ( p< 0,001) in the irradiated melanomas than in the control tumours. Conclusion. High-dose (106)Ruthenium plaque brachytherapy turned out to be an effective treatment procedure for posterior uveal melanoma ( not exceeding a prominence of 5,5 mm) with a high rate of local tumour control and a low rate of side effects.