Palladium-103 brachytherapy deemed safe, pupil-sparing treatment

Iris melanoma treated with palladium-103 plaque brachytherapy showed patterns of regression that included decreased intrinsic tumor vascularity, increased tumor pigmentation and decreased tumor thickness, according to a study.

Palladium-103 (Pd) ophthalmic plaque radiation therapy is used to treat iris melanoma by preserving normal iris tissue and function compared with less conservative treatment options: iridectomy, iridocyclectomy and enucleation.

This retrospective, nonrandomized chart review of 50 patients with iris melanoma treated with Pd plaque therapy between 1998 and 2015 aimed to document the patterns of change after treatment. The mean prescription dose of those studied was 84.5 Gy for a mean duration of 163.3 hours.

Mean pigmentation in the tumors reviewed increased in 32 cases (64%); in the remainder, pigmentation decreased or showed no change.

Mean tumor thickness decreased from a mean of 1.4 mm to 0.9 mm.

Vascularity decreased over time after therapy in all 19 tumors with documented intrinsic vascularity, with complete resolution is seven cases (37%).

After brachytherapy, ectropion uveae diminished in 43% of tumors; however, newly present corectopia was seen in 12% of eyes. There were no irreversible sight-limiting complications reported.

“With 100% local and systemic control at a mean duration of 63 months after Pd plaque brachytherapy, we found this to be a safe and effective pupil-sparing treatment for iris melanomas,” the researchers wrote. – by Rebecca L. Forand

Disclosure: The study authors report no relevant financial disclosures.

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Source:

Chaugule SS, et al. Ophthalmology. 2017;doi:10.1016/j.ophtha.2017.02.015.