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Dosimetric comparison of ¹⁰⁶Ru and ¹²⁵I plaques for treatment of shallow (5 mm) choroidal melanoma lesions

Departments of ¹ Radiation Oncology and, ² Ophthalmic Oncology, Cole Eye Institute and ³ Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, OH, USA

Correspondence: D. Allan Wilkinson, Department of Radiation Oncology, Desk T-28, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. E-mail: wilkina{at}ccf.org

The aim of this study was to compare dosimetric parameters between iodine–125 (¹²⁵I) and ruthenium–106 (¹⁰⁶Ru) plaques of similar sizes in the treatment of choroidal melanomas. The study design included retrospective double planning of each case. 26 consecutive patients with choroidal melanomas measuring 5 mm or less in thickness were included. Dose distributions were calculated using Plaque Simulator treatment-planning software for a prescription of 85 Gy to the tumour apex. Doses to the outer sclera, lens, fovea and optic disc were obtained for each case using appropriately sized plaques of each isotope. Statistical inferences were made using the non-parametric Wilcoxon signed rank test. The mean dose to the macula, disc and lens was 18%, 53% and 89% less, respectively, with ¹⁰⁶Ru than with ¹²⁵I. Scleral doses were greater for ¹⁰⁶Ru. The use of collaborative ocular melanoma study dosimetry results in even higher mean doses to the macula, disc, lens and sclera. Two-dimensional dose distributions and dose volume histograms demonstrated the increase in dose outside the tumour volume using ¹²⁵I. This comparison shows that, for tumours not exceeding 5 mm in thickness, the use of ¹⁰⁶Ru plaques has the potential to reduce the radiation dose to nearby normal structures and possibly lower the risk of radiation-induced visual loss.

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				N Kaiserman, I Kaiserman, K Hendler, S Frenkel, and J Pe'er Ruthenium-106 plaque brachytherapy for thick posterior uveal melanomas Br J Ophthalmol, September 1, 2009; 93(9): 1167 - 1171. [Abstract] [Full Text] [PDF]