Ruthenium-106 Plaque Radiotherapy for Treatment of Uveal Malignant Melanoma: 15 years’ Experience in Tertiary Referral Hospital in Iran

Purpose: To report the outcome of the Ruthenium-106 eye plaque brachytherapy in patients with uveal malignant melanoma over 15 years in tertiary referral hospital In Iran.Methods: In this retrospective study, the charts of all patients with the diagnosis of uveal malignant melanoma who underwent Ruthenium-106 plaque brachytherapy from 2002 to 2017 were reviewed. All patients had to have at least 6 months of follow up. Clinical features, brachytherapy parameters, outcomes and complications were evaluated.Results: Two hundred and ninety four patients were included. Of them 130 (44.2%) were male. Mean age of patients was 52.14 ± 14.67 years (range 15 to 86). The location of the tumors was choroid in 215 (73.1 %), ciliochoroid in 38 (12.9 %), iridociliary in 31 (10.5 %), iridiociliochoroid in 6 (2 %) and ciliary body in 4 (1.4 %) of the cases. Mean follow up duration was 29.50 ± 19.66 months (range 6 to 80). Mean radiation time was 128.19 ± 73.81 hours. Mean apex dose and mean scleral dose were 8683.00 ± 2167.86 cGy, and 75757.44 ± 44237.08 cGy respectively. The most frequent used plaque type was CCB in 40 (13 %) of cases. The tumor thickness 5.62 ± 2.30 mm in baseline decreased to 3.36 ± 1.94 mm in last follow up. (P<0.001). The mean preoperative visual acuity was 0.67 LogMAR which increased to 1.01 LogmMAR at last visit. (P<0.001). Final globe survival was94%. Tumor recurrence was occurred in 29 (9%) of Patients. Second plaque brachytherapy was performed in 10 (3%) and enucleation was done in 18 (6%) of the cases. Adjuvant Transpupillary thermotherapy (TTT) and cataract surgery was performed in 35.6 % and 26.7 % of patients, respectively. Conclusion: Ruthenium-106 plaque radiotherapy is an effective and safe method of treatment for choroidal malignant melanoma