Outcomes following Notched Ruthenium-106 Plaque Brachytherapy for Juxtapapillary Choroidal Melanomas

Manvi Manu Sobti; Magdalena Edington; Julie Connolly; David J McLernon; Stefano Schipani; Diana Ritchie; Paul Cauchi; Vikas Chadha

doi:10.1159/000518975

Outcomes following Notched Ruthenium-106 Plaque Brachytherapy for Juxtapapillary Choroidal Melanomas

Manvi Manu Sobti^* (Corresponding Author), Magdalena Edington, Julie Connolly, David J McLernon, Stefano Schipani, Diana Ritchie, Paul Cauchi, Vikas Chadha

^*Corresponding author for this work

Gartnavel General Hospital

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

PURPOSE: This study aimed to evaluate the outcomes of juxtapapillary choroidal melanomas treated with notched ruthenium-106 plaques.

METHODS: Juxtapapillary choroidal melanomas (tumours within 2 disc diameters from the optic disc) treated with notched ruthenium-106 plaques (Eckert & Ziegler, BEBIG, Berlin, Germany) at the Scottish Ocular Oncology Service between 2009 and 2015 were retrospectively reviewed. The data were analysed with respect to various outcome measures including recurrence, complications, vision, and eye preservation.

RESULTS: We reviewed 40 patients with a median tumour diameter of 8.4 mm (range 5-17 mm) and a median thickness of 2.5 mm (range 1.1-6 mm). AJCC tumour category distribution was 62.5% T1, 32.5% T2, and 5% T3 tumours. The mean presenting vision was 0.3 logMAR, and the mean final vision was 0.7 logMAR, with 62.5% retaining >1.0 logMAR and 50% retaining >0.3 logMAR at the final follow-up. The median follow-up was 51 months (14-100 months). Over the maximum follow-up time, 13 tumours (32.5%) recurred. Six of these were treated with salvage proton beam therapy (PBT), 2 with transpupillary thermotherapy followed by PBT, and 5 with enucleation. The final eye retention rate was 87.5%. Complications included maculopathy (10%), retinal detachment (5%), neovascular glaucoma (2.5%), and diplopia (2.5%). The observed risk of recurrence over 5 years was 31% (95% CI: 14.1%, 47.8%), and the risk of enucleation over 5 years was 11.5% (95% CI: 0.9%, 21.8%).

CONCLUSION: Juxtapapillary choroidal melanomas treated with notched ruthenium plaques have a high recurrence rate and frequently need salvage treatment with PBT for tumour control. This has led to a change in our practice toward offering PBT as the first-line treatment for these patients.

Original language	English
Pages (from-to)	411-417
Number of pages	7
Journal	Ocular oncology and pathology
Volume	7
Issue number	6
Early online date	23 Aug 2021
DOIs	https://doi.org/10.1159/000518975
Publication status	Published - 1 Dec 2021

Bibliographical note

Acknowledgment:
The authors thank Susan Ewan for facilitating data collection for the study. These data were presented by M.S. at the first United Kingdom Ocular Oncology Conference at Sheffield in 2019 and won the best presentation prize.

Funding Sources:
None.

Data Availability Statement

The data that support the findings of this study are not publicly available as the data belong to NHS Greater Clyde but are available from the corresponding author (M.S.) upon reasonable request. Permission from the Caldicott Guardian was obtained for the purpose of the study.

Keywords

Juxtapapillary choroidal melanoma
COB plaque
Notched plaque
Ruthenium-106
Brachytherapy

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@article{039bac245f1841a78a47f2e5c133d3d6,

title = "Outcomes following Notched Ruthenium-106 Plaque Brachytherapy for Juxtapapillary Choroidal Melanomas",

abstract = "PURPOSE: This study aimed to evaluate the outcomes of juxtapapillary choroidal melanomas treated with notched ruthenium-106 plaques.METHODS: Juxtapapillary choroidal melanomas (tumours within 2 disc diameters from the optic disc) treated with notched ruthenium-106 plaques (Eckert & Ziegler, BEBIG, Berlin, Germany) at the Scottish Ocular Oncology Service between 2009 and 2015 were retrospectively reviewed. The data were analysed with respect to various outcome measures including recurrence, complications, vision, and eye preservation.RESULTS: We reviewed 40 patients with a median tumour diameter of 8.4 mm (range 5-17 mm) and a median thickness of 2.5 mm (range 1.1-6 mm). AJCC tumour category distribution was 62.5% T1, 32.5% T2, and 5% T3 tumours. The mean presenting vision was 0.3 logMAR, and the mean final vision was 0.7 logMAR, with 62.5% retaining >1.0 logMAR and 50% retaining >0.3 logMAR at the final follow-up. The median follow-up was 51 months (14-100 months). Over the maximum follow-up time, 13 tumours (32.5%) recurred. Six of these were treated with salvage proton beam therapy (PBT), 2 with transpupillary thermotherapy followed by PBT, and 5 with enucleation. The final eye retention rate was 87.5%. Complications included maculopathy (10%), retinal detachment (5%), neovascular glaucoma (2.5%), and diplopia (2.5%). The observed risk of recurrence over 5 years was 31% (95% CI: 14.1%, 47.8%), and the risk of enucleation over 5 years was 11.5% (95% CI: 0.9%, 21.8%).CONCLUSION: Juxtapapillary choroidal melanomas treated with notched ruthenium plaques have a high recurrence rate and frequently need salvage treatment with PBT for tumour control. This has led to a change in our practice toward offering PBT as the first-line treatment for these patients.",

keywords = "Juxtapapillary choroidal melanoma, COB plaque, Notched plaque, Ruthenium-106, Brachytherapy",

author = "Sobti, {Manvi Manu} and Magdalena Edington and Julie Connolly and McLernon, {David J} and Stefano Schipani and Diana Ritchie and Paul Cauchi and Vikas Chadha",

note = "Acknowledgment: The authors thank Susan Ewan for facilitating data collection for the study. These data were presented by M.S. at the first United Kingdom Ocular Oncology Conference at Sheffield in 2019 and won the best presentation prize. Funding Sources: None.",

year = "2021",

month = dec,

day = "1",

doi = "10.1159/000518975",

language = "English",

volume = "7",

pages = "411--417",

journal = "Ocular oncology and pathology",

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T1 - Outcomes following Notched Ruthenium-106 Plaque Brachytherapy for Juxtapapillary Choroidal Melanomas

AU - Sobti, Manvi Manu

AU - Edington, Magdalena

AU - Connolly, Julie

AU - McLernon, David J

AU - Schipani, Stefano

AU - Ritchie, Diana

AU - Cauchi, Paul

AU - Chadha, Vikas

N1 - Acknowledgment: The authors thank Susan Ewan for facilitating data collection for the study. These data were presented by M.S. at the first United Kingdom Ocular Oncology Conference at Sheffield in 2019 and won the best presentation prize. Funding Sources: None.

PY - 2021/12/1

Y1 - 2021/12/1

N2 - PURPOSE: This study aimed to evaluate the outcomes of juxtapapillary choroidal melanomas treated with notched ruthenium-106 plaques.METHODS: Juxtapapillary choroidal melanomas (tumours within 2 disc diameters from the optic disc) treated with notched ruthenium-106 plaques (Eckert & Ziegler, BEBIG, Berlin, Germany) at the Scottish Ocular Oncology Service between 2009 and 2015 were retrospectively reviewed. The data were analysed with respect to various outcome measures including recurrence, complications, vision, and eye preservation.RESULTS: We reviewed 40 patients with a median tumour diameter of 8.4 mm (range 5-17 mm) and a median thickness of 2.5 mm (range 1.1-6 mm). AJCC tumour category distribution was 62.5% T1, 32.5% T2, and 5% T3 tumours. The mean presenting vision was 0.3 logMAR, and the mean final vision was 0.7 logMAR, with 62.5% retaining >1.0 logMAR and 50% retaining >0.3 logMAR at the final follow-up. The median follow-up was 51 months (14-100 months). Over the maximum follow-up time, 13 tumours (32.5%) recurred. Six of these were treated with salvage proton beam therapy (PBT), 2 with transpupillary thermotherapy followed by PBT, and 5 with enucleation. The final eye retention rate was 87.5%. Complications included maculopathy (10%), retinal detachment (5%), neovascular glaucoma (2.5%), and diplopia (2.5%). The observed risk of recurrence over 5 years was 31% (95% CI: 14.1%, 47.8%), and the risk of enucleation over 5 years was 11.5% (95% CI: 0.9%, 21.8%).CONCLUSION: Juxtapapillary choroidal melanomas treated with notched ruthenium plaques have a high recurrence rate and frequently need salvage treatment with PBT for tumour control. This has led to a change in our practice toward offering PBT as the first-line treatment for these patients.

AB - PURPOSE: This study aimed to evaluate the outcomes of juxtapapillary choroidal melanomas treated with notched ruthenium-106 plaques.METHODS: Juxtapapillary choroidal melanomas (tumours within 2 disc diameters from the optic disc) treated with notched ruthenium-106 plaques (Eckert & Ziegler, BEBIG, Berlin, Germany) at the Scottish Ocular Oncology Service between 2009 and 2015 were retrospectively reviewed. The data were analysed with respect to various outcome measures including recurrence, complications, vision, and eye preservation.RESULTS: We reviewed 40 patients with a median tumour diameter of 8.4 mm (range 5-17 mm) and a median thickness of 2.5 mm (range 1.1-6 mm). AJCC tumour category distribution was 62.5% T1, 32.5% T2, and 5% T3 tumours. The mean presenting vision was 0.3 logMAR, and the mean final vision was 0.7 logMAR, with 62.5% retaining >1.0 logMAR and 50% retaining >0.3 logMAR at the final follow-up. The median follow-up was 51 months (14-100 months). Over the maximum follow-up time, 13 tumours (32.5%) recurred. Six of these were treated with salvage proton beam therapy (PBT), 2 with transpupillary thermotherapy followed by PBT, and 5 with enucleation. The final eye retention rate was 87.5%. Complications included maculopathy (10%), retinal detachment (5%), neovascular glaucoma (2.5%), and diplopia (2.5%). The observed risk of recurrence over 5 years was 31% (95% CI: 14.1%, 47.8%), and the risk of enucleation over 5 years was 11.5% (95% CI: 0.9%, 21.8%).CONCLUSION: Juxtapapillary choroidal melanomas treated with notched ruthenium plaques have a high recurrence rate and frequently need salvage treatment with PBT for tumour control. This has led to a change in our practice toward offering PBT as the first-line treatment for these patients.

KW - Juxtapapillary choroidal melanoma

KW - COB plaque

KW - Notched plaque

KW - Ruthenium-106

KW - Brachytherapy

UR - https://europepmc.org/article/med/35087818

U2 - 10.1159/000518975

DO - 10.1159/000518975

M3 - Article

C2 - 35087818

SN - 2296-4681

VL - 7

SP - 411

EP - 417

JO - Ocular oncology and pathology

JF - Ocular oncology and pathology

IS - 6

ER -

Outcomes following Notched Ruthenium-106 Plaque Brachytherapy for Juxtapapillary Choroidal Melanomas

Abstract

Bibliographical note

Data Availability Statement

Keywords

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