Abstract
Purpose: :
To compare Iodine 125 (I125) and Ruthenium 106 (Ru106) plaque radiotherapy for uveal melanomas measuring 5-7 mm in thickness with regard to treatment complications and tumor control.
Methods: :
Patients with tumor thickness of 5-7 mm presented between February 2007 and October 2010 were randomly assigned to plaque treatment with I125, group A (14 pts), or Ru106 group B (12 pts). Clinical data regarding features of the patient and tumor, as well as radiation parameters, were gathered prospectively. The clinical data were then analyzed with regard to four outcomes of radiation maculopathy, enucleation, local tumor recurrence, and metastasis.
Results: :
Clinical and ultrasound data of group A and group B were as follow: mean age (67 vs 65 years, range 42-82) , mean tumor thickness (6.43 vs 5.34mm, range 5.0-6.9), mean tumor largest basal diameter (11.85 vs 11.33mm, range 7.53-14.40). Mean follow was 24.2 months (range 14.3-38.7 ) in group A and 30.2 months (range 7.6-48.3) in group B . Treatment with I125 resulted in higher rate of radiation maculopathy (14.3% vs 8.3% respectively), lower rate of enucleation (7.1% vs 8.3% respectively), lower rate of tumor recurrence (7.1% vs 8.3% respectively), and lower rate of metastasis (0% vs 25% respectively). The differences were not significant on univariate level (P > 0.05), except for metastasis rate. The mean interval between treatment and onset of metastatic disease was 30.5 months.
Conclusions: :
The management of choroidal melanoma with a thickness of 5-7 mm is controversial. Iodine seems to provide higher local tumor control, while Ruthenium induces less radiation complications. Although there are several limitations to our study, we found that I125 represents a better option in these subgroup of tumors, especially for preventing metastatic disease.
Keywords: tumors • melanoma • radiation therapy