Palladium-103 radiation therapy for small choroidal melanoma

Purpose: To evaluate outcomes after ophthalmic plaque radiation therapy for small choroidal melanomas. Design: Retrospective study, case series. Participants: Seventy-two patients with choroidal melanomas ≥1.5 and ≤2.4 mm apical height and ≤10 mm width treated between 2002 and 2012, with a minimum follow-up of 8 months. Methods: All patients were treated with palladium-103 plaque brachytherapy. Mean radiation dose to the tumor apex was 82.4 Gy (range, 70.0-102 Gy). Main Outcome Measures: Local control, radiation complications, visual acuity, and metastatic rate. Results: Plaque radiotherapy provided 100% local tumor control and eye retention at a mean 54 months of observation (95% confidence interval, 46-63 months). The most common long-term brachytherapy-related complications were radiation maculopathy (43.1%) and radiation optic neuropathy (20.8%) developing at a mean of 27 months (range, 9-72 months) after irradiation. In this series, 94.4% of patients maintained 20/200 or better vision. There has been no small choroidal melanoma-related metastasis. Conclusions: Palladium-103 plaque radiation therapy offered excellent local control and visual acuity outcomes for patients with small choroidal melanoma. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.