Radiation complications and tumor control after 125I plaque brachytherapy for ocular melanoma

Int J Radiat Oncol Biol Phys. 2005 Sep 1;63(1):101-8. doi: 10.1016/j.ijrobp.2005.01.022.


Purpose: To determine the outcome of 125I plaque brachytherapy at our institution and identify the risk factors associated with the development of radiation complications, tumor recurrence, and metastasis.

Patients and methods: From 1986 to 2000, 156 patients underwent 125I episcleral plaque (COMS design) application for the treatment of ocular melanoma. Chart analysis of follow-up ophthalmologic appointments assessed the incidence of ocular side effects after therapy. Statistical analysis assessed outcomes and significant influencing factors.

Results: With a median follow-up of 6.2 years, the 5-year overall survival was 83%. The 5-year disease-specific survival was 91%. Initial local control at 5 years was 92%, with 100% ultimate local control after secondary therapy that included 9 enucleations. The risk of metastasis was 10% at 5 years and 27% at 10 years. Vision stayed the same or improved in 25% of patients, and 44% of patients maintained visual acuity better than 20/200. Thirteen percent of patients experienced chronic pain or discomfort in the treated eye. Dose rates to the tumor apex greater than 90 to 100 cGy/h were associated with increased systemic control but worse radiation toxicity.

Conclusion: Patients in our series experienced excellent local tumor control. Higher dose rates to the tumor apex were associated with reduced rates of distant metastases but worse ocular function.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Brachytherapy / adverse effects*
  • Brachytherapy / methods
  • Choroid Neoplasms / pathology
  • Choroid Neoplasms / radiotherapy*
  • Eye / radiation effects
  • Female
  • Humans
  • Iodine Radioisotopes / adverse effects*
  • Iodine Radioisotopes / therapeutic use
  • Male
  • Melanoma / pathology
  • Melanoma / radiotherapy*
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Radiation Injuries / etiology
  • Survival Analysis
  • Vision Disorders / etiology
  • Visual Acuity / radiation effects


  • Iodine Radioisotopes