Adjuvant brachytherapy with ruthenium-106 to reduce the risk of recurrence of conjunctival melanoma after excision

Abstract

Introduction: Local recurrence of conjunctival melanoma (CM) is common after excision. Local radiotherapy is an effective adjuvant treatment option, and brachytherapy with ruthenium (106Ru) is one such option. Thus, herein, we aimed to describe our experience with and the clinical results of postexcision adjuvant 106Ru plaque brachytherapy in patients with CM. Methods: Nineteen patients (8 men and 11 women) received adjuvant brachytherapy with a 106Ru plaque after tumor excision. The mean adjuvant dose administered was 109 Gy (range, 80–134 Gy), and a depth of only 2.2 mm was targeted because the tumor had been excised. A full ophthalmological examination including visual acuity testing, slit-lamp examination, and indirect ophthalmoscopy was performed before therapy and at every postoperative follow-up. The mean follow-up period was 62 months (range, 2–144 months). Results: Three patients developed a recurrence in a nontreated area, either at the conjunctiva bulbi or the conjunctiva tarsi. None of the patients developed a recurrence in the treated area. The local control rate was 84% (16/19). Conclusion: 106Ru plaque brachytherapy is an effective adjuvant treatment to minimize the risk of local recurrence after excision of a CM. Patients have to be followed-up regularly and carefully for the early detection of recurrence.