Original Paper

Tumour Regression of Uveal Melanoma after Ruthenium-106 Brachytherapy or Stereotactic Radiotherapy with Gamma Knife or Linear Accelerator
Michael Georgopoulos, Martin Zehetmayer, Irene Ruhswurm, Sabine Toma-Bstaendig, Nikolaus Ségur-Eltz, Stefan Sacu, Rupert Menapace

Department of Ophthalmology, Medical School, University of Vienna, Vienna, Austria

Address of Corresponding Author

Ophthalmologica 2003;217:315-319 (DOI: 10.1159/000071345)

  Key Words

• Uveal melanoma
• Radiotherapy
• Ruthenium
• Gamma knife
• Linear-accelerator-based stereotactic teletherapy
• Ultrasound

  Abstract

Purpose: This study assesses differences in relative tumour regression and internal acoustic reflectivity after 3 methods of radiotherapy for uveal melanoma: (1) brachytherapy with ruthenium-106 radioactive plaques (RU), (2) fractionated high-dose gamma knife stereotactic irradiation in 2-3 fractions (GK) or (3) fractionated linear-accelerator-based stereotactic teletherapy in 5 fractions (Linac). Methods: Ultrasound measurements of tumour thickness and internal reflectivity were performed with standardised A scan pre-operatively and 3, 6, 9, 12, 18, 24 and 36 months postoperatively. Of 211 patients included in the study, 111 had a complete 3-year follow-up (RU: 41, GK: 37, Linac: 33). Differences in tumour thickness and internal reflectivity were assessed with analysis of variance, and post hoc multiple comparisons were calculated with Tukey's honestly significant difference test. Results: Local tumour control was excellent with all 3 methods (>93%). At 36 months, relative tumour height reduction was 69, 50 and 30% after RU, GK and Linac, respectively. In all 3 treatment groups, internal reflectivity increased from about 30% initially to 60-70% 3 years after treatment. Conclusion: Brachytherapy with ruthenium-106 plaques results in a faster tumour regression as compared to teletherapy with gamma knife or Linac. Internal reflectivity increases comparably in all 3 groups. Besides tumour growth arrest, increasing internal reflectivity is considered as an important factor indicating successful treatment.

Copyright © 2003 S. Karger AG, Basel

  Author Contacts

Michael Georgopoulos, MD
Universitätsklinik für Augenheilkunde und Optometrie
Allgemeines Krankenhaus Wien, Währinger Gürtel 18-20
AT-1090 Wien (Austria)
Tel./Fax +43 1 40400 4520, E-Mail michael.georgopoulos@akh-wien.ac.at

  Article Information

Received: November 18, 2002
Accepted after revision: February 27, 2003
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 1, Number of References : 30