Ruthenium-106 Plaque Brachytherapy for the Management of Intraocular Tumors in Thailand: The First Report from Southeast Asia.

Background: Report the results of Ruthenium plaque brachytherapy (¹⁰⁶Ru) for the management of intraocular tumors in Thailand.

Methods: We retrospectively reviewed the medical records of 46 eyes of 45 patients who received ¹⁰⁶Ru brachytherapy for the treatment of various intraocular tumors in the Department of Ophthalmology of Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, between April 2013 and December 2020.

Results: Of 46 eyes, 21 (46%) were diagnosed with small to medium choroidal melanoma, 13 (28%) with retinoblastoma, 4 (9%) with choroidal metastases, 2 (4%) with retinal vasoproliferative tumor (VPT), 3 (7%) with choroidal hemangioma (CH), 2 (4%) with RPE adenoma, and 1 (2%) with retinal hemangioblastoma. The mean tumor thickness was 4.8 mm (range, 2.4-6.6). After a mean follow-up of 62.4 months (range, 4.8-122.7), local tumor control was achieved in 39 eyes (85%), which were 100% for choroidal melanoma, 46% for RB, 100% for choroidal metastasis and 100% for benign tumors. Radiation-related complications were found in 28 eyes (61%), including cataracts in 10 (25%), radiation retinopathy in 14 (30%), radiation maculopathy in 14 (30%), radiation papillopathy in 6 (13%), and vitreous hemorrhage in 3 (7%) eyes. All patients with retinoblastoma currently alive without metastasis. Two patients with choroidal melanoma developed systemic metastases and three patients with choroidal metastases died at the end of the study.

Conclusions: Patients with intraocular tumors treated with ¹⁰⁶Ru brachytherapy showed excellent outcomes in relation to tumor control with few complications.