RESULTS OF TREATMENT OF CHOROIDAL MALIGNANT-MELANOMA WITH HIGH-DOSE-RATE SR-90 BRACHYTHERAPY - A RETROSPECTIVE STUDY OF 46 PATIENTS TREATEDBETWEEN 1983 AND 1995

Purpose: We review the results of treatment of small to medium-sized c horoidal malignant melanomas after high-dose-rate brachytherapy with a strontium-90 applicator. Methods: The applicator is positioned agains t the sclera using an afterloading technique. Brachytherapy is complet ed in a single session lasting 2-4 h with the patient under local anae sthesia. From September 1983 until March 1995, 46 eyes were treated in this way. Most tumours were 7-11 mm in diameter (range from 4.5-15 mm ) with a mean height of approximately 3 mm (range from 1.5-7 mm). Foll ow-up ranged from 6 months to 12 years (mean 49 months). Results: Thir ty of the 46 eyes had at the final evaluation a non-evolutive scar (20 of these after a single application, the others with some additional treatment). In 13 eyes the rumours were in involution but their comple te destruction was not yet certain, and 3 eyes were enucleated for loc al recurrence. Three patients developed systemic metastases. No radiog enic complications were noticed. Conclusion: Strontium-90 brachytherap y is a valuable and safe treatment technique for small to medium-sized choroidal malignant melanomas. In addition the use of a strontium-90 applicator is inexpensive thanks to this element's long half-life and the short application time.