Combined Plaque Radiotherapy and Transpupillary Thermotherapy for Choroidal Melanoma

Abstract

To evaluate tumor control and treatment complications following plaque radiotherapy combined with transpupillary thermotherapy for choroidal melanoma.

Choroidal Melanoma: Natural History and Management Options

“…Various materials for delivering radiation have been investigated, beginning with radon in the 1930s by Moore. 28 Iodine-125 is currently the most commonly used isotope for plaque radiotherapy of choroidal melanomas, 29,30 although cobalt-60, ruthenium-106, iridium-192, strontium-90, and palladium-103 have also been used. Modern techniques for plaque brachytherapy involve suturing a shielded plaque containing seeds of the radioactive isotope to the sclera.…”

Choroidal melanoma recurrence after episcleral brachytherapy and transpupillary thermotherapy

“…Combined plaque radiotherapy and TTT has been shown to provide excellent control of intraocular tumors. Shields et al (3) and Bartlema et al (4) reviewed 270 and 50 cases, respectively, and found recurrence rates at 5 years after treatment of up to 3%. However, neither study found any cases of extraocular extension.…”

“…Secondary extraocular extension following conservative treatment of CM is extremely rare (3) and usually small in size. Historically, this pre sentation has been associated with surgical resection and TTT without adjuvant brachytherapy thought to result in insufficient elimination of tumor margins and intrascleral tumor cells.…”

Laser and proton radiation to reduce uveal melanoma–associated exudative retinal detachments

“…We and others have noted significant enhancement of radiation effects from heat in animal models of uveal melanoma. 13 Several investigators [14][15][16][17] have used a combination of this form of laser-induced hyperthermia plus brachytherapy to treat uveal melanomas. In a recent study, Shields and colleagues 17 noted increased tumor control, nearing that achieved with charged particles when this form of laser is used after I-125 brachytherapy.…”