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. 2024 Sep;10(3):162-167.
doi: 10.1159/000539684. Epub 2024 Jun 11.

Adjuvant Brachytherapy with Ruthenium-106 to Reduce the Risk of Recurrence of Conjunctival Melanoma after Excision

Luise Grajewski  1 , Christiane Kneifel  1 , Markus Wösle  2 , Ilja F Ciernik  2 , Lothar Krause  1
Affiliations

Adjuvant Brachytherapy with Ruthenium-106 to Reduce the Risk of Recurrence of Conjunctival Melanoma after Excision

Luise Grajewski et al. Ocul Oncol Pathol. 2024 Sep.

Abstract

Introduction: Local recurrence of conjunctival melanoma (CM) is common after excision. Local radiotherapy is an effective adjuvant treatment option, and brachytherapy with ruthenium-106 (106Ru) is one such option. Thus, herein, we aimed to describe our experience with and the clinical results of post-excision 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, at either 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.

Keywords: Brachytherapy; Conjunctival melanoma; Recurrence rate; Ruthenium-106.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
a Malignant melanoma of the conjunctiva with clear cell abrasion in the tear pool (b). c Magnified image of the area seen in (a) and (b).
Fig. 2.
Fig. 2.
Post-excision treatment of the site of CM with a 106Ru plaque.
Fig. 3.
Fig. 3.
a Area after tumor excision and irradiation (*). b Non-pigmented histologically confirmed recurrence (arrow) adjacent to the irradiated area.
Fig. 4.
Fig. 4.
Kaplan-Meier recurrence-free survival curve with lower or upper bound.
See this image and copyright information in PMC

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