R. Boutrus1,2, G. N. Eskandar3, S. F. Lasheen4, E. M. Abdelrahman5, M. Bayomy6, and I. S. Othman3,7; 1National Eye Center, cairo, Egypt, 2Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt, 3National Eye Center, Cairo, Egypt, 4Department of Clinical Oncology, Kasr Al-Ainy, Cairo University, Cairo, Egypt, 5Radiation Oncology Department, National Cancer Institute Cairo University,, Cairo, Egypt, 6Clinical Oncology Department, Zagazig University., Zagazig, Egypt, 7Opthalmology Department, Kasr Al Aini Hospital, Cairo University, Cairo, Egypt
Purpose/Objective(s): To assess rates local recurrence (LRR), useful vision, complications, distant metastases (DM) and overall survival (OS) in patients treated with PLSU and adjuvant BRT. Materials/
Methods: The medical records of twenty-one patients with UM, not candidates for BRT alone, treated with PLSU and BRT from January 2017 till February 2022, were reviewed. Patients received median radiation dose of 85 Gy (range, 80-100), calculated at 3 mm depth, assuming a 1 mm scleral thickness. Useful vision was defined as VA = 0.2 on the decimal scale. Results: Median follow-up was 49 months (range, 21-84). Median tumor thickness was 7.3 mm (range, 4.6-12.2) and median tumor largest basal diameter (LBD) was 12 mm (range,8-18). Eight patients (28.6%) had local recurrence. Seven patients (33.3%) had deterioration in their visual acuity during follow-up and one patient reported improvement in vision. Four patients (19%) underwent enucleation with globe preservation rate of 81%. One patient (4.7%) developed distant metastases during follow-up and one patient died due to unrelated cause. Eight patients (38.1%) developed vitreous hemorrhage, eight patients (38.1%) had subretinal fluid accumulation and six patients (28.6%) developed cataract. Conclusion: Adjuvant Ruthenium brachytherapy after PLSU is a good alternative to enucleation in patients who are not candidates for brachytherapy alone with excellent globe preservation rate. However, visual acuity deteriorated in substantial percentage of patients.
