Results of ruthenium irradiation of uveal melanomas: the Dutch experience

Background ann purpose: To update our results of the treatment of uveal:mel anomas using ruthenium applicators in 49 patients treated with graded doses and subsequently in 52 patients with maximal scleral doses of 800 Gy and a n effective top dose of at least 160 Gy. Material and methods: One hundred and one patients were treated with brachy therapy only, in 25 patients it was combined with transpupillary thermother apy (TTT). Results: A complete remission was found in 62.6% of the patients and in 31. 3% a stable disease with an average follow-up of 74.6 months, Above a topdo se of 120 Gy only in one of 95 patients continuous tumour growth after trea tment was observed. Useful vision could be preserved in 51.5% of the patien ts. The initial tumour prominence and top dose strongly correlated with tre atment outcome. Conclusions: Ruthenium application for uveal melanomas with the doses we ha ve used is successful, with a substantial number of patients having their e yes preserved, their tumour controlled and their vision retained. Further i mprovements can be obtained with ruthenium irradiation with lower maximal s cleral doses combined with TTT. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.