A choice of radionuclide: Comparative outcomes and toxicity of ruthenium-106 and iodine-125 in the definitive treatment of uveal melanoma.

Vinita Takiar, K Ranh Voong, Dan S Gombos, Firas Mourtada, Laura A Rechner, Ann A Lawyer, William H Morrison, Adam S Garden, Beth M Beadle

Journal: Practical radiation oncology 2016;5(3):e169-e176

PMID: 25423888

Full Text on Elsevier Science View on PubMed

Abstract

PURPOSE

Both iodine-125 ((125)I) Collaborative Ocular Melanoma Study and ruthenium-106 ((106)Ru) eye plaques can achieve excellent tumor control in patients diagnosed with uveal melanoma. We analyzed our single institutional experience in the management of ocular melanoma treated with either (125)I or (106)Ru plaque brachytherapy.

METHODS AND MATERIALS

The records of 107 patients with uveal melanoma treated with either (106)Ru (n = 40) or (125)I (n = 67) plaque brachytherapy between 2000 and 2008 were retrospectively reviewed. Tumor control parameters and toxicity were assessed.

RESULTS

Actuarial 5-year rates of local control, progression-free survival, and overall survival with (106)Ru were 97%, 94%, and 92%, respectively. For (125)I, these values were 83%, 65%, and 80%. In the subset of patients with tumor apex height ≤5 mm (36 (125)I and 40 (106)Ru), there was no difference in overall survival; however, progression-free survival was significantly improved with (106)Ru (P = .02). Enucleation-free survival was significantly different between the 2 subsets, with no enucleations in the (106)Ru cohort (P = .02). Patients treated with (106)Ru experienced reduced retinopathy (P = .03) and cataracts (P < .01).

CONCLUSIONS

Both (125)I and (106)Ru eye plaque brachytherapy treatment result in encouraging tumor control for patients with uveal melanoma. We demonstrate that (106)Ru offers these benefits with reduced toxicity in patients treated for uveal melanomas ≤5 mm in apical height.

Address: Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.; Department of Ophthalmology, University of Texas MD Anderson Cancer Center, Houston, Texas.; Department of Radiation Oncology, Helen F. Graham Cancer Center, Christiana Care Health System, Newark, Delaware, and Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.; Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas.; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: [email protected].

DOI: 10.1016/j.prro.2014.09.005

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MeSH Terms: Adult, Aged, Aged, 80 and over, Brachytherapy, Disease-Free Survival, Female, Humans, Iodine Radioisotopes, Male, Melanoma, Middle Aged, Retrospective Studies, Ruthenium Radioisotopes, Treatment Outcome, Uveal Neoplasms, Uveal Melanoma