urvival, anatomic, and functional long-term reult in choroidal and ciliary body melanoma after ruthenium brachytherapy (15 year’ experience with beta-ray)

Purpoe To analyze urvival, radiation-related complication, local recurrence, enucleation, and viual acuity after ruthenium-106 irradiation of malignant uveal melanoma. Deign Retropective tudy. Method A total of 213 patient treated with ruthenium-106 brachytherapy between 1983 and 1995. End point rate were etimated by life table, and prognotic factor by Cox proportional hazard regreion. Main outcome meaure were urvival rate, radiation-related maculopathy, radiation-related vacular occluion, local tumor recurrence, enucleation, and viual acuity (<20/100 at 3 year). Reult At 5 and 10 year, urvival wa 82% (tandard error [E] 2.7%) and 72% (E 3.4%), local recurrence 21.7% (E 3.0%) and 24.3% (E 3.2%), and enucleation 18.0% (E 2.7%) and 19.2% (E 2.8%), repectively. ixty-one patient howed maculopathy (29%), 36 retinal vacular occluion (17%), in 33 local recurrence (16%), and 38 enucleation (18%). Age and large tumor diameter were independently aociated with urvival (P< .0001 and P< .0075, repectively). Age below 40 and melanoma located poteriorly were ignificant rik factor for maculopathy (P< .0085 and P< .0004, repectively) and vacular occluion (P< .0415 and P< .0114, repectively). Diameter and Bruch membrane rupture were ignificant predictor (P< .0032 and P< .0390, repectively) of local recurrence. Viual acuity <20/100 wa oberved in only 26 of 97 (27%) cae of anterior but 34 of 42 (81%) of poterior tumor (P< .001). Concluion Although percentage tumor recurrence wa high, urvival wa comparable to erie uing other treatment. Radiation-related complication rate were acceptable, epecially for anterior tumor. Ruthenium therapy can, therefore, be recommended for mall and medium-ized tumor with anterior location.