Abstract
Purpose: :
To investigate the clinical features, rate of mortality and results of ruthenium (Ru)-106 plaque brachytherapy of choroidal melanoma in Korean patients.
Methods: :
A retrospective analysis of 132 choroidal melanoma patients who were diagnosed and managed from September, 1993 to October, 2010 was performed. Initial findings, treatments received, visual acuity and incidence of metastatic mortality were recorded. Kaplan-Meier survival curves were used to estimate the rate of metastatic mortality, visual preservation rate and secondary enucleation rate. Univariate Cox proportional hazards regression was performed to evaluate which factors predicted metastatic death.
Results: :
The mean age of patients at diagnosis was 51.2 years (range: 18-88) and there were 70 (53%) male patients. Tumors had a mean largest basal diameter of 10.8 mm (range: 2.5-19.26) and a mean height of 7.0 mm (range: 1-15.64). Among them, 118 patients with medium to large sized tumor (COMS criteria) were treated; 62 (52.5%) with Ru-106 plaque brachytherapy with or without transpupillary thermotherapy; 32 (27.1%) with primary enucleation; 22 (18.6%) with gamma knife radiotherapy (GKR); 2 (1.7%) with local excision. The 5-year tumor-specific survival rate was 87.9% in medium to large sized tumor and the factor predicting tumor-specific survival outcome were age, tumor diameter and height in the univariate analyses. The 5-year tumor-specific survival rate in the patients treated with Ru-106 brachytherapy was 89.9% and the factor predicting tumor-specific survival outcome were tumor diameter and secondary enucleation in the univariate analyses. Of the 62 patients who treated with brachytherapy, 27 (43.5%) patients maintained their vision to within 2 lines on the standard Snellen eye chart, and the 3-year actuarial rate of visual preservation was 46.4%. Ten patients eventually underwent enucleation or excenteration 14.5 (range: 6-32) months after brachytherapy with a 3-year cumulative incidence of 16.7%.
Conclusions: :
This is the first report about prognosis of brachytherapy for malignant melanoma in Asian. This study confirms that the prognosis of malignant melanoma and results of Ru-106 brachytherapy in Koreans are similar to previously reported results.
Keywords: melanoma • tumors • choroid