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L. Razzaq, J. E. E. Keunen, N. Schalij-Delfos, M. J. Jager, C. L. Creutzberg, R. J. W. de Keizer; Ruthenium Plaque Radiation Therapy for Iris and Iridociliary Melanomas and Its Complications. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5156.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the effect of Ruthenium-106 plaque radiation therapy for iris and iridociliary melanomas in terms of tumor regression and complications, especially dry eye problems.
38 patients with an iris or iridociliary melanoma were treated with Ruthenium-106 plaque radiation therapy between November 1, 1997 and December 31, 2008. The median follow-up was 6 years with a range of 1.5 - 11 years. The mean age of the patients was 60 years. The mean tumor apex dose was 152 Gy. Main outcome measures were tumor control and ocular complications with special consideration of dry eye problems.
The tumors had a median length of 4.6 mm (range 1.7 - 11) and a prominence of 2.5 mm (range 0.8 - 5), with a median involvement of three clock hours (range 1 - 6). The tumors were confined to the iris in 16 patients (42%). In 22 patients, the tumor was present in both the iris as well as the ciliary body, with the main tumor location being the iris in ten (26%) and the ciliary body in 12 patients (32%). Following Ru plaque application all tumors responded with a mean regression of 80% of original tumor size at seven years of follow-up. Radiation-related complications included corneal erosions on the first post-operative day in nine patients (24%), cataract in four patients (28%) and post-radiation glaucoma in one patient (2.6%). Enucleation was performed in two patients (5.2%) post-treatment because of tumor recurrence. Distant metastases occurred in one of these patients (2.6%) two years after irradiation. Three patients complained of dry eyes (7.8%) out of which one patient had complaints in both the eyes. The difference in the mean values of BUT between the treated and untreated eyes was -0.09 with a p-value of 0.88. For the Schirmer test the difference between mean values of treated and untreated eyes was 0.13 with a p-value of 0.87.
Ruthenium-106 plaque radiation therapy for iris and iridociliary melanoma resulted in good local tumor control and treatable side-effects, while hardly any patients developed dry eye problems.
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