Cutom-deigned plaque radiotherapy for nonreectable iri melanoma in 38 patient: tumor control and ocular complication

Purpoe To evaluate plaque radiotherapy for iri melanoma. Deign Propective noncomparative interventional cae erie. Method For 38 patient, cutom-deigned plaque radiotherapy uing iodine 125 iotope wa applied overlying the cornea with a tumor apex doe of 80 Gy. The main outcome meaure were tumor control and ocular complication uing Kaplan-Meier etimate and Cox proportional hazard regreion analyi. Reult In all cae, the melanoma wa nonreectable owing to large or dicoheive tumor. The tumor configuration wa nodular in 24 cae (63%) and flat (diffue) in 14 (37%). The mean tumor baal diameter wa 9 mm (range 4 to 13 mm). olid tumor extended into the anterior chamber angle in 36 eye (95%). Tumor eed were noted on the iri troma for a mean of 7 clock hour and in the anterior chamber angle for a mean of 4 clock hour. Five-year follow up revealed tumor metatai in 0% and tumor recurrence in 8% of patient. Viual acuity of 20/200 or wore wa found in 16% at 5 year. Radiation-related complication at 5 year included corneal epitheliopathy (9%), cataract (70%), and neovacular glaucoma (8%). No patient developed corneal necroi, cleral necroi, retinopathy, or papillopathy. After treatment, the combined incidence of tumor-related and radiation-related elevated intraocular preure at 5 year wa 33%. Enucleation wa neceary in 13% at 5 year, for tumor recurrence (n = 3) and patient preference (n = 1). Concluion Plaque radiotherapy i a ueful alternative to enucleation for eye with nonreectable iri melanoma. Tumor control i 92% at 5 year, but related complication, epecially cataract and elevated intraocular preure, hould be anticipated.