Episcleral iridium-192 wire therapy for choroidal melanomas

Int J Radiat Oncol Biol Phys. 1994 Dec 1;30(5):1091-7. doi: 10.1016/0360-3016(94)90314-x.


Purpose: To evaluate the effectivity of high-dose episcleral iridium-192 wires in the treatment of choroidal melanoma.

Methods and materials: In 1983, the Departments of Radiation Oncology and Ophthalmology at the Clínica Puerta de Hierro, Madrid, Spain, initiated a clinical study using removable episcleral iridium-192 wires in the treatment of choroidal melanoma. Sixty-six evaluable patients were treated from January 1983 through July 1992. Two patients had a small sized tumor (3%), 28 had a medium sized tumor (42%), and 36 patients had a large tumor (54%). The mean follow-up was 40 months (6-118 months). The dose to the apex of the tumor ranged from 66 to 97 Gy (mean 76.6 Gy), and the doses at 2 mm depth ranged from 77 to 433 Gy (mean 200 Gy).

Results: Tumor regression or stabilization was observed in 53 of the 66 patients (90%). Visual acuity improved following treatment in 5 out of 54 patients (9%), remaining unchanged in 30 out of 54 (56%), and decreased in 19 out of 54 (35%) patients. The remaining seven patients had undergone enucleation. Late complications have been documented in 20 out of 66 patients (30%), including 6 patients in whom enucleation was required because of radiation-related complications. The probability of survival and survival free of local progression was 93% at 5 years and 79% at 10 years. The probability of retaining the treated eye is 82% after the fifth year posttreatment.

Conclusions: Treatment of choroidal melanomas with episcleral iridium-192 wires is as effective as treatment with other radioactive applications. We feel that our results using iridium-192 wires are comparable to the other methods. However, we think that our technique is simple to implement, relatively inexpensive, and well tolerated.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Brachytherapy / methods*
  • Choroid Neoplasms / mortality
  • Choroid Neoplasms / pathology
  • Choroid Neoplasms / physiopathology
  • Choroid Neoplasms / radiotherapy*
  • Eye Enucleation
  • Follow-Up Studies
  • Humans
  • Iridium Radioisotopes / therapeutic use*
  • Melanoma / mortality
  • Melanoma / pathology
  • Melanoma / physiopathology
  • Melanoma / radiotherapy*
  • Neoplasm Metastasis
  • Probability
  • Survival Rate
  • Time Factors
  • Visual Acuity


  • Iridium Radioisotopes