Ruthenium-106 Plaque Brachytherapy for the Management of Intraocular Tumors in Thailand: The First Report from Southeast Asia

BackgroundReport the results of Ruthenium plaque brachytherapy (106Ru) for the management of intraocular tumors in Thailand.MethodsWe retrospectively reviewed the medical records of 46 eyes of 45 patients who received 106Ru brachytherapy for the treatment of various intraocular tumors in the Department of Ophthalmology of Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, between April 2013 and December 2020.ResultsOf 46 eyes, 21 (46%) were diagnosed with small to medium choroidal melanoma, 13 (28%) with retinoblastoma, 4 (9%) with choroidal metastases, 2 (4%) with retinal vasoproliferative tumor (VPT), 3 (7%) with choroidal hemangioma (CH), 2 (4%) with RPE adenoma, and 1 (2%) with retinal hemangioblastoma. The mean tumor thickness was 4.8 mm (range, 2.4-6.6). After a mean follow-up of 62.4 months (range, 4.8-122.7), local tumor control was achieved in 39 eyes (85%), which were 100% for choroidal melanoma, 46% for RB, 100% for choroidal metastasis and 100% for benign tumors. Radiation-related complications were found in 28 eyes (61%), including cataracts in 10 (25%), radiation retinopathy in 14 (30%), radiation maculopathy in 14 (30%), radiation papillopathy in 6 (13%), and vitreous hemorrhage in 3 (7%) eyes. All patients with retinoblastoma currently alive without metastasis. Two patients with choroidal melanoma developed systemic metastases and three patients with choroidal metastases died at the end of the study.ConclusionsPatients with intraocular tumors treated with 106Ru brachytherapy showed excellent outcomes in relation to tumor control with few complications.