Lack of radiation maculopathy after palladium-103 plaque radiotherapy for iris melanoma

Int J Radiat Oncol Biol Phys. 2012 Jul 15;83(4):1107-12. doi: 10.1016/j.ijrobp.2011.09.033. Epub 2011 Dec 13.

Abstract

Purpose: To report on the risk of radiation maculopathy for iris and iridociliary melanomas treated by (103)Pd plaque radiotherapy.

Methods and materials: This is a retrospective clinical case series of 30 eyes in 30 patients with melanomas limited to the iris or invading the ciliary body. The main outcome measures included demographic information, laterality, tumor size, location, visual acuity, radiation dose, local control, retinal evaluation, and duration of follow-up.

Results: Thirty patients were followed for a median 36 months (range, 12-90 months). Sixteen of 30 tumors (53%) were pure iris melanomas, and 14 (47%) were primary iris melanomas extending into the ciliary body. Radiation dosimetry showed that the median tumor apex dose was 85 Gy (range, 75-100 Gy), lens dose 43.5 Gy (range, 17.8-60 Gy), fovea dose 1.8 Gy (range, 1.3-5 Gy), and central optic disc dose 1.7 Gy (range, 1.3-4.7 Gy). Cataracts developed in 20 of the 28 phakic eyes (71.4%). No patient in this series developed radiation maculopathy or radiation optic neuropathy. Last best-corrected visual acuity was ≥ 20/25 in 28 patients (93%) at a median 36 months' follow-up.

Conclusion: Though visual acuities were transiently affected by radiation cataract, no radiation maculopathy or optic neuropathy has been noted after (103)Pd treatment of iris and iridociliary melanomas.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brachytherapy / adverse effects
  • Brachytherapy / methods
  • Cataract / etiology
  • Female
  • Follow-Up Studies
  • Fovea Centralis / radiation effects
  • Humans
  • Iris Neoplasms / radiotherapy*
  • Lens, Crystalline / radiation effects
  • Macula Lutea / radiation effects*
  • Male
  • Melanoma / radiotherapy*
  • Middle Aged
  • Optic Disk / radiation effects
  • Organs at Risk / radiation effects
  • Palladium / adverse effects
  • Palladium / therapeutic use*
  • Radioisotopes / adverse effects
  • Radioisotopes / therapeutic use*
  • Radiotherapy Dosage
  • Retinal Diseases / etiology*
  • Retrospective Studies
  • Risk Assessment
  • Visual Acuity / radiation effects

Substances

  • Radioisotopes
  • Palladium