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Enucleation ‘infrequent’ after brachytherapy, study finds

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BETHESDA, Md. — Iodine 125 brachytherapy helps to achieve local tumor control and decreases enucleation risks, results of a large-scale study found.

The Collaborative Ocular Melanoma study (COMS) compared effective iodine 125 brachytherapy rates to those for iodine 125 brachytherapy requiring enucleation. Patients enrolled typically had tumors ranging in size from 2.5 mm to 10 mm. Tumors were no more than 16 mm in longest basal dimensions.

Brachytherapy was administered through an episcleral plaque according to a standard protocol; follow-up was every 6 months for 5 years, and then at yearly intervals. Of the 650 patients assigned to brachytherapy, 411 had been followed for at least 5 years. In that time, 69 eyes were enucleated and 57 eyes reported treatment failure. The most common reason for enucleation within 3 years of treatment was treatment failure; beyond that time frame, ocular pain was the most common reason.

The report is published in Ophthalmology.