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A. Totah, I. Pifano, S. Ciobataru; Treatment of Basal Cell Carcinoma of the Eyelid with Ruthenium 106 Radioctive Plaque. Report of Two Cases . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2439.
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Purpose: Basal cell carcinoma (BCC) is the most common malignant tumor of the eyelids. It represents 80%-90% of all malignant eyelid neoplasms. Treatment options include surgical excision, cryotherapy, curettage with electrodessication, radiotherapy, chemotherapy, photodynamic therapy and topical 5-fluorouracil. Primary BCC 5 year cure rate is about 95% with external beam radiation but ocular complications includes epiphora, eyelash loss, dry eye and cataract. We intend to evaluate tumor control and ocular complications following ruthenium 106 plaque radiotherapy for BCC of the eyelid. Methods: Two cases of biopsy proven BCC of the eyelid with infiltrated margins were treated with radioactive ruthenium 106 plaque. Case 1: a 67 year old female, morphea type, lower rigth eyelid . Case 2: a 47 year old male, nodular type, lower left orbital rim. The apical depth was 2.5 mm. and 3.0 mm. respectively. The deliver contact dose applied was 4500 cGy in the first case and 5000 cGy in the second case, two days fractionated dose. Results: Both tumors showed local control within two and three months respectively and a complete response within six and eight months of follow up. Side effects include: mild erythema in both cases and eyelash loss in one case. Conclusions: The use of radioactive ruthenium 106 plaques in the management of BCC with pathologically positive margins of up to 3-4 mm. in height seems to be highly effective and a safe modality of treatment that provides good cosmetic results, avoids complications of external beam radiation, big surgical reconstructions and warrants further investigation.
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