Iodine ‐125 episcleral brachytherapy for uveal melanoma : 133 cases

Abstract

Purpose To assess the results of I125 Episcleral Brachytherapy (EB) in uveal melanoma: tumor control, visual acuity, eye preservation and survival Methods Prospective and consecutive study of patients with the diagnosis of uveal melanoma at the ocular oncology unit in the Valladolid University Hospital treated with EB between september 1997 and june 2008. Ocular examination, extraocular and systemic extension data have been registered in a database at the time of the diagnosis and during the follow up. Results Among a total of 310 patients diagnosed between September 1997 and June 2008, 133 were treated with EB with a mean age of 58.6 years. Mean follow up was 45.4 months. The onset was symptomatic in 78.2% and 66.9% were nodular and 30.1% mushroom shape. Regarding the size 80.5% were medium, 7.5 % small and 12% large. The median tumor height were 5.7 mm and median basal diameter 12 mm. The median dose to tumor apex delivered 89.6 Gy. After 4.9 year of follow up tumor were controlled in 99% with a 57.9% reduction in the mean height; only two patients showed recurrence; 64.1.% maintain visual acuity > 0.1 and 33.3% > 0.5 with . Only 7 patients underwent enucleation due to complications and there are 1 death related to melanoma up to date. Conclusion I125 Episcleral Brachytherapy is effective regarding tumour control, allowing preservation of the eye and useful visual function for the majority of patients with uveal melanoma.